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1.
MedUNAB ; 25(1): 9-30, 202205.
Article in Spanish | LILACS | ID: biblio-1372572

ABSTRACT

Introducción. La COVID-19 ha sido una de las enfermedades que ha generado mayor carga de enfermedad en el siglo XXI. A la fecha, se estiman más de 280 millones de casos a nivel global. Aún se desconocen muchos aspectos de esta condición, lo que ocasiona controversias sobre el abordaje de pacientes críticamente enfermos. La traqueostomía es una intervención que ha demostrado ser beneficiosa en el manejo de enfermedades respiratorias, sin embargo, existe un vacío en la evidencia sobre la efectividad y seguridad de esta intervención en pacientes críticamente enfermos de COVID-19. Por lo anterior, el objetivo de este estudio consistió en relacionar el tiempo transcurrido desde el inicio del cuadro clínico, durante la intubación y los días de ventilación mecánica, hasta la realización de la traqueostomía, con la supervivencia de pacientes con síntomas sugestivos de COVID-19. Metodología. Estudio retrospectivo de corte transversal, realizado entre marzo del año 2020 y febrero del año 2021 en dos centros hospitalarios de cuarto nivel de la ciudad de Cartagena, Colombia. Incluyó pacientes mayores de 18 años que ingresaron a la unidad de cuidados intensivos por requerimiento de ventilación mecánica invasiva por sintomatología respiratoria viral. Se excluyeron aquellos con historias clínicas incompletas e internados por otras causas respiratorias. Resultados. Un total de 122 pacientes fueron incluidos en el estudio con una mediana de edad de 63 años (RIQ 22; 20-89), siendo el 66.4% (n=81) hombres. No se encontró una correlación significativa entre el número de días desde el inicio del cuadro clínico hasta realización de la traqueostomía (p=0.12), ni entre el tiempo transcurrido desde la intubación endotraqueal hasta la realización de la traqueostomía, con respecto a la supervivencia (p=0.53). Pero sí entre el número de días de ventilación mecánica invasiva y el desenlace final (p=0.02). Discusión. Aunque se ha reportado que la traqueostomía es uno de los procedimientos que acarrea mayores riesgos en el manejo del paciente con sintomatología respiratoria severa, durante la pandemia por COVID-19 la literatura describe que esta intervención aumenta la supervivencia, disminuye el tiempo de requerimiento de ventilación mecánica y reduce la estancia en unidad de cuidados intensivos. El número de complicaciones es muy bajo en comparación al beneficio que otorga y se observó que el comportamiento local es muy similar al reportado en la literatura. Conclusiones. El tiempo desde el inicio de los síntomas o de la intubación endotraqueal hasta la realización de traqueostomía no se correlaciona con la supervivencia de pacientes con sintomatología respiratoria sugestiva de COVID-19 que se encuentran bajo ventilación mecánica y traqueostomizados.


Introduction. COVID-19 has generated one of the highest disease burdens in the 21st century. To date, there are more than 280 million estimated cases globally. Many aspects of this condition are still unknown, which causes controversy in how to approach critically ill patients. Tracheostomy is an intervention that has been shown to be beneficial in the management of respiratory disease, however, there is an evidence gap on the effectiveness and safety of this intervention in critically ill COVID-19 patients. Consequently, the aim of this study was to relate the time elapsed from the onset of the clinical condition, during intubation and days of mechanical ventilation, to performing the tracheostomy, with the survival of patients with symptoms suggestive of COVID-19. Methodology. Retrospective cross-sectional study, conducted between March 2020 and February 2021 in two fourth-level hospitals in the city of Cartagena, Colombia. It included patients older than 18 years who were admitted to the intensive care unit due to the need for invasive mechanical ventilation for viral respiratory symptoms. Those with incomplete medical records and hospitalized for other respiratory causes were excluded. Results. A total of 122 patients were included in the study with a median age of 63 years (IQR 22; 20-89), with 66.4% (n = 81) being male. No significant correlation was found between the number of days from the onset of the clinical condition to the performance of tracheostomy (p = 0.12), nor between the time elapsed from endotracheal intubation to the performance of tracheostomy, with respect to survival (p = 0.53). However, there was a relationship between the number of days of invasive mechanical ventilation and the final outcome (p = 0.02). Discussion. Although it has been reported that tracheostomy is one of the riskiest procedures in the management of patients with severe respiratory symptoms, during the COVID-19 pandemic the literature describes that this intervention increases survival, decreases the time required for mechanical ventilation and reduces the length of stay in the intensive care unit. The number of complications is very low in comparison to the benefit it confers, and it was observed that the local behavior is very similar to that reported in the literature. Conclusions. Time from symptom onset or endotracheal intubation to the performance of tracheostomy does not correlate with survival in patients with respiratory symptomatology suggestive of COVID-19 who are mechanically ventilated and tracheostomized.


Introdução. A COVID-19 tem sido uma das doenças que gerou a maior carga de doenças no século XXI. Até o momento, mais de 280 milhões de casos são estimados globalmente. Muitos aspectos dessa condição ainda são desconhecidos, o que gera controvérsias sobre a abordagem de pacientes gravemente doentes. A traqueostomia é uma intervenção que tem se mostrado benéfica no manejo de doenças respiratórias, porém, há uma lacuna nas evidências sobre a eficácia e segurança dessa intervenção em pacientes críticos com COVID-19. Portanto, o objetivo deste estudo foi relacionar o tempo decorrido desde o início do quadro clínico, durante a intubação e os dias de ventilação mecânica, até a realização da traqueostomia, com a sobrevivência de pacientes com sintomas sugestivos de COVID-19. Metodologia. Estudo transversal retrospectivo, realizado entre março de 2020 e fevereiro de 2021 em dois hospitais de quarto nível na cidade de Cartagena, Colômbia. Foram incluídos pacientes maiores de 18 anos que foram admitidos na unidade de terapia intensiva por necessidade de ventilação mecânica invasiva devido a sintomas respiratórios virais. Foram excluídos aqueles com historial clínico incompleto e internados por outras causas respiratórias. Resultados. Um total de 122 pacientes foram incluídos no estudo com idade média de 63 anos (IQR 22; 20-89), sendo 66.4% (n=81) homens. Não foi encontrada correlação significativa entre o número de dias desde o início do quadro clínico até a traqueostomia (p=0.12), ou entre o tempo decorrido da intubação endotraqueal até a traqueostomia, com relação à sobrevivência (p=0.53). Mas sim entre o número de dias de ventilação mecânica invasiva e o desfecho final (p=0.02). Discussão. Embora tenha sido relatado que a traqueostomia é um dos procedimentos de maior risco no manejo de pacientes com sintomas respiratórios graves, durante a pandemia de COVID-19 a literatura descreve que essa intervenção aumenta a sobrevivência, diminui o tempo necessário para a ventilação mecânica e reduz a permanência na unidade de terapia intensiva. O número de complicações é muito baixo em relação ao benefício que proporciona e observou-se que o comportamento local é muito semelhante ao relatado na literatura. Conclusões. O tempo desde o início dos sintomas ou intubação endotraqueal até a realização de uma traqueostomia não se correlaciona com a sobrevivência de pacientes com sintomas respiratórios sugestivos de COVID-19 que estão sob ventilação mecânica e traqueostomizados.


Subject(s)
Tracheostomy , Coronavirus Infections , Respiration, Artificial , Respiratory Tract Diseases , Colombia , COVID-19
2.
Prensa méd. argent ; 108(2): 108-112, 20220000. tab
Article in English | LILACS | ID: biblio-1368488

ABSTRACT

Los pacientes con infección perioperatoria por COVID-19 tienen un alto riesgo de muerte y complicaciones posoperatorias. En la actualidad, la infección por COVID-19 en Irak representó 1.696.390 casos con 19.087 muertes. Un estudio nacional, único y observacional que incluyó pacientes con infección por COVID-19 que se sometieron a cualquier tipo de cirugía en el Hospital General de Abu-Graib, Bagdad, Irak, durante el período del 19 de marzo de 2020 al 30 de abril de 2021. Tiempo desde el diagnóstico de la infección por COVID-19 El día de la cirugía se recogió como factor categórico dividido en: (a) 0-3 semanas; (b) 4­6 semanas; (c) >6 semanas. Edad; sexo; estado físico de la Sociedad Americana de Anestesiólogos (ASA); comorbilidades cardíacas; comorbilidades respiratorias; indicación de cirugía; grado de cirugía; y se documentaron los tipos quirúrgicos. Se incluyeron un total de 378 pacientes con una edad media de 47,89±16,03 años. Las mujeres eran más que los hombres (65,87% > 34,13%). Aproximadamente, el 76,72% de los pacientes pertenecían a ASA I-II, mientras que el 23,28% eran ASA III-IV. Alrededor del 19,05% de los pacientes sufría de comorbilidades cardíacas. 266/378 de los pacientes se quejaron de comorbilidades respiratorias. Cirugía indicada en 35,45% condiciones benignas, 27,5% obstetricia, 7,65% cirugía oncológica y 29,4% operaciones traumáticas. Operaciones mayores documentadas en 205/378 pacientes. Las intervenciones quirúrgicas de urgencia realizadas en (176, 46,56%), mientras que los casos electivos fueron 202/378 (53,44%). En total, en el momento de la operación, 80 (21,16 %) pacientes tenían un diagnóstico preoperatorio de COVID-19. El tiempo desde el diagnóstico de COVID-19 hasta la cirugía fue de 0 a 3 semanas en 98 pacientes (25,93 %), de 4 a 6 semanas en 115 pacientes (30,42 %) y >6 semanas en 165 pacientes (43,65 %). La tasa de mortalidad postoperatoria global fue del 9,52% (36/378). Con respecto a la complicación cardiaca de la O.P., no hubo asociación significativa en relación al momento previo a la cirugía (p=0,08). Sin embargo, la complicación cardíaca global fue del 16,4%. En general, el 44,97 % (170/378) de los pacientes desarrollaron una complicación pulmonar por O.P. durante el período de seguimiento. Hasta donde sabemos, este es el primer estudio que proporciona datos sólidos sobre el momento óptimo para la cirugía después de la infección por COVID-19 en Irak. El momento óptimo de la cirugía después de la infección por COVID-19 fue de más de 6 semanas. Descubrimos que los riesgos de morbilidad y mortalidad por O.P. son mayores si los pacientes son operados dentro de las 6 semanas posteriores al diagnóstico de infección por COVID-19.


Patients with perioperative COVID-19 infection are at high risk of death and complications postoperatively. Nowadays, COVID-19 infection in Iraq accounted 1,696,390 cases with 19,087 deaths. A national, single, and observational study that included patients with COVID-19 infection undergoing any type of surgery in Abu-Graib General Hospital, Baghdad Iraq during period from 19 March 2020 to 30 April 2021. Time from the diagnosis of COVID-19 infection to day of surgery was collected as a categorical factor divided into: (a) 0­3 wks; (b) 4­6 wks; (c) >6 wks. Age; sex; American Society of Anesthesiologists (ASA) physical status; cardiac comorbidities; respiratory comorbidities; indication for surgery; surgery grade; and surgical types were documented. A total of 378 patient were included with mean age was 47.89±16.03 years. Females were more than males (65.87% > 34.13%). Approximately, 76.72% of patients belonged within ASA I-II, whereas 23.28% were ASA III-IV. About 19.05% of patients suffered from cardiac comorbidities. 266/378 of patients complained from respiratory comorbidities. Surgery indicated in 35.45% benign conditions, 27.5% obstetrics, 7.65% oncological surgery, and 29.4% traumatic operations. Major operations documented in 205/378 patients. Emergencies surgical intervention done in (176, 46.56%), whereas elective cases were 202/378 (53.44%). In total at operation timing, 80(21.16%) patients had a preoperative COVID-19 diagnosis. The time from COVID-19 diagnosis to surgery was 0­3 weeks in 98 patients (25.93%), 4­6 weeks in 115 patients (30.42%), and >6 weeks in 165 patients (43.65%). The overall postoperative mortality rate was 9.52% (36/378). In regard to P. O. cardiac complication, there was no significant association in relation to timing before surgery (p=0.08). However, the overall cardiac complication was 16.4%. Overall, 44.97% (170/378) of patients developed a P. O. pulmonary complication within period of follow-up. To our knowledge this is the first study to provide strong data regarding the optimal timing for surgery following COVID-19 infection in Iraq. The optimal timing of surgery after COVID-19 infection was more than 6 wks. We found that risks of P. O. morbidity and mortality are greatest if patients are operated within 6 wks of diagnosis of COVID-19 infection


Subject(s)
Humans , Adult , Middle Aged , Aged , Respiratory Tract Diseases/complications , Comorbidity , Aftercare , Emergencies , COVID-19/surgery , COVID-19/complications , Heart Diseases/complications , Time Factors
3.
Univ. salud ; 24(1): 76-84, ene.-abr. 2022. tab
Article in Spanish | LILACS-Express | LILACS, COLNAL | ID: biblio-1361188

ABSTRACT

Introducción: La COVID-19 es una enfermedad que desencadena infecciones respiratorias graves como el síndrome respiratorio agudo severo, que puede requerir atención prolongada intra y extrahospitalaria. Objetivo: Brindar recomendaciones y pautas para una correcta evaluación y tratamiento del paciente con COVID-19 mediante la rehabilitación pulmonar. Materiales y métodos: Revisión de la literatura en las bases de datos MEDLINE, PEDRO, Scielo y en Google Scholar, a partir de las palabras clave: COVID-19, Síndrome de Dificultad Respiratoria del Adulto, Enfermedades pulmonares, Rehabilitación, pruebas de función respiratoria, Unidad de cuidado intensivo; seleccionando, aquellos artículos que presentaran información sobre rehabilitación en pacientes con COVID-19 y otras alteraciones con compromiso similar como el Síndrome Respiratorio Agudo y las Enfermedades Pulmonares Intersticiales Difusas. Resultados: Para realizar una intervención en paciente con COVID-19 u otra alteración respiratoria como Síndrome de Dificultad Respiratoria del Adulto y Enfermedad Pulmonar Intersticial Difusa, es necesario realizar un adecuado diagnóstico de la enfermedad, una minuciosa evaluación integral y una intervención basada en las necesidades de cada individuo. Conclusiones: El paciente intrahospitalario puede recibir intervención enfocada a evitar el deterioro funcional y una vez son dados de alta la rehabilitación pulmonar extrahospitalaria podría ser una alternativa eficaz en el tratamiento para los pacientes.


Introduction: COVID-19 is a disease that triggers serious respiratory infections such as severe acute respiratory syndrome, which requires treatment on an inpatient and outpatient basis. Objective: To provide recommendations and guidelines for the appropriate assessment and treatment of COVID-19 patients through pulmonary rehabilitation. Materials and methods: A literature review using MEDLINE, PEDRO, Scielo and Google Scholar databases and the keywords: COVID-19, Adult Respiratory Distress Syndrome, Pulmonary diseases, Rehabilitation, Respiratory function tests, Intensive Care Unit. Articles that described information regarding rehabilitation in COVID-19 patients and other similar dysfunctions such as Acute Respiratory Syndrome and Diffuse Interstitial Lung Diseases. Results: It is necessary to carry out an appropriate disease diagnosis, a detailed integral assessment, and an intervention based on the needs of each patient in order to intervene with either COVID-19 patients or cases with other respiratory dysfunctions such as Adult Respiratory Distress Syndrome and Diffuse Interstitial Lung Disease. Conclusions: Inpatients can be subjected to an intervention focused on avoiding functional failure. Once they are discharged, outpatient pulmonary rehabilitation could be an effective treatment alternative for these patients.


Subject(s)
Humans , Rehabilitation , Respiratory Tract Diseases , Respiratory Distress Syndrome, Newborn , Respiratory Function Tests , Respiratory Tract Infections , Lung Diseases, Interstitial , Critical Care , Lung Diseases
4.
Univ. salud ; 24(1): 45-54, ene.-abr. 2022. tab
Article in Spanish | LILACS-Express | LILACS, COLNAL | ID: biblio-1361185

ABSTRACT

Introducción: El efecto deletéreo de material particulado fino exterior sobre la salud respiratoria de la población de niños y de adultos mayores, es de interés en salud pública. Objetivo: Establecer el efecto de la contaminación por Material Particulado de menos de 2,5 μm de diámetro (PM2,5), sobre la Enfermedad Respiratoria Aguda (ERA) en los menores de 5 y personas de mínimo 65 años, ajustado por variables meteorológicas y climáticas, en los municipios del Área Metropolitana del Valle de Aburrá (Colombia), 2008 a 2015. Materiales y métodos: Estudio ecológico con información de la red de vigilancia de calidad del aire y de registros de prestación de servicios de salud. Se construyeron Modelos Aditivos Generalizados con función de enlace Poisson y suavización spline. Para cada rezago distribuido se calculó la medida de la asociación e intervalo de confianza. Resultados: Los casos de ERA aumentaron significativamente en los menores de 5 años en Envigado y Caldas (43,3% vs 29,6%) y en los de 65 y más años, en Medellín (13,2%) por cada incremento de 10 µg/m3 en PM2,5 al día quince a partir de la exposición. Conclusiones: Los eventos diarios respiratorios tuvieron especial frecuencia en Medellín y en municipios de la zona sur.


Introduction: The harmful effect of fine particulate matter on the respiratory health of child and elderly populations is a concern for public health. Objective: To establish the effect of pollution by less than 2.5 μm in diameter (PM2.5) particulate matter on Acute Respiratory Disease (ARD) during 2008-2015 in children younger than 5 and adults older than 65 from the Metropolitan Area of the Aburrá Valley (Colombia), adjusting for meteorological and climate variables. Materials and methods: Ecological study with information from the air quality surveillance network and individual records of health providers. Generalized Additive Models were developed using smoothing spline Poisson models. The assessment of the association and confidence intervals were calculated for each distributed lag. Results: For each 10 µg/m3 increment in PM2,5 and the day 15 post-exposure, ARD cases increased significantly in populations who are younger than 5 and older than 65 in Envigado and Caldas (43.3% vs. 29.6%) and Medellín (13.2%), respectively. Conclusions: Daily respiratory events had a special frequency in Medellín and the municipalities of the southern region.


Subject(s)
Humans , Child, Preschool , Aged , Aged, 80 and over , Health , Environment , Respiratory Tract Diseases , Public Health , Disease , Air Pollution , Environmental Pollution , Particulate Matter
5.
Rev. Ciênc. Plur ; 8(2): e25243, mar. 2022. tab
Article in Portuguese | LILACS, BBO | ID: biblio-1368175

ABSTRACT

Introdução:As doenças do aparelho respiratório se configuram como o segundo principal motivo de internações hospitalares no Brasil entre 2013 e 2017. Objetivo:Analisar a morbimortalidade de doenças do aparelho respiratório da população brasileira, segundo faixa etária,no período compreendido entre os anos de 2015 a 2019. Metodologia:Trata-se de um estudo do tipo ecológico, retrospectivo, realizado sobre o território brasileiro. Os dados foram coletados a partir do Departamento de Informática do Sistema Único de Saúde, nas seções de Morbidade Hospitalar, de Mortalidade e População Residente. Foram analisados os dados entre 2015 a 2019 e de todas as faixas etárias. Resultados:Ao investigar a mortalidade por doenças do sistema respiratório entre os anos de 2015 e 2019, as cinco causas mais frequentes foram: influenza e pneumonia; doenças crônicas das vias aéreas inferiores; outras doenças do aparelho respiratório; outras doenças respiratórias que afetam principalmente interstício; doenças pulmonares devidas a agentes externos, nessa ordem. Enquanto as cinco causas de morbidades mais frequentes foram: pneumonia; outras doenças do aparelho respiratório; bronquite, enfisema e outras doenças pulmonares obstrutivas crônicas; asma; bronquite aguda e bronquiolite aguda. Conclusões:Verificou-se que a pneumonia, influenza, doenças respiratórias do trato inferior e outras doenças crônicas respiratórias foram as mais prevalentes entre a população respectivamente. Dentre o público mais acometido, foi possível constatar que o público infantil e a população idosa foram os mais atingidos tanto na mortalidade quanto na morbidade (AU).


Introduction:Introduction: Respiratory diseases are the second main reason for hospital admissions in Brazil between 2013 and 2017. Objective:To analyze the morbidity and mortality of respiratory diseases of the Brazilian population, according to age group, in the period from 2015 to 2019. Methodology:This is an ecological, retrospective study conducted on the Brazilian territory. Data were collected from the Informatics Department of the Unified Health System, in the Sections of Hospital Morbidity, Mortality and Resident Population. Data were analyzed between 2015 and 2019 and all age groups. Results:When investigating mortality from respiratory system diseases between 2015 and 2019, the five most frequent causes were: influenza and pneumonia; chronic diseases of the lower airways; other diseases of the respiratory system; other respiratory diseases that mainly affect interstitium; diseases due to external agents, in that order. Conclusions:It was found that pneumonia, influenza, respiratory diseases of the lower tract and other chronic respiratory diseases were the most prevalent among the population, respectively. Among the most affected public, it was possible to observe that the child's public and the elderly population were the most affected in both mortality and morbidity (AU).


Introducción: Las enfermedades respiratorias son la segunda razón principal de los ingresos hospitalarios en Brasil entre 2013 y 2017. Objetivo: Analizar la morbilidad y mortalidad de las enfermedades respiratorias de la población brasileña, según el grupo de edad, en el período comprendido entre 2015 y 2019.Metodología: Se trata de un estudio ecológico y retrospectivo realizado en territorio brasileño. Los datos fueron recogidos del Departamento de Informática del Sistema Unificado de Salud, en las Secciones de Morbilidad Hospitalaria, Mortalidad y Población Residente. Los datos se analizaron entre 2015 y 2019 y todos los grupos de edad. Resultados: Al investigar la mortalidad por enfermedades del sistema respiratorio entre 2015 y 2019, las cinco causas más frecuentes fueron: gripe y neumonía; enfermedades crónicas de las vías respiratorias inferiores; otras enfermedades del sistema respiratorio; otras enfermedades respiratorias que afectan principalmente al intersticio; enfermedades debidas a agentes externos, en ese orden.Mientras que las cinco causas más frecuentes de morbilidad fueron: neumonía; otras enfermedades del sistema respiratorio; bronquitis, enfisema y otras enfermedades pulmonares obstructivas crónicas; asma; bronquiolitis aguda y bronquiolitis aguda. While the five most frequent causes of morbidities were: pneumonia; other diseases of the respiratory system; bronchitis, emphysema and other chronic obstructive pulmonary diseases; asthma; acute bronchitis and acute bronchiolitis. Conclusiones: Se encontróque la neumonía, la influenza, las enfermedades respiratorias de las vías inferiores y otras enfermedades respiratorias crónicas eran las más prevalentes entre la población, respectivamente. Entre el público más afectado, se pudo observar que el público del niño y la población de edad avanzada eran los más afectados tanto en la mortalidad como en la morbilidad (AU).


Subject(s)
Humans , Male , Female , Respiratory System/anatomy & histology , Respiratory Tract Diseases/pathology , Brazil/epidemiology , Indicators of Morbidity and Mortality , Retrospective Studies , Data Interpretation, Statistical , Ecological Studies , Age Groups
6.
Rev. Ciênc. Méd. Biol. (Impr.) ; 20(4): 520-525, fev 11, 2022. ilus
Article in Portuguese | LILACS | ID: biblio-1359306

ABSTRACT

Introdução: as infecções respiratórias das vias aéreas são frequentes no nosso meio. O combate dessas infecções ocorre por meio da introdução dos antimicrobianos, quando indicados, e a profilaxia através da imunização, reduzindo a incidência das infecções e suas complicações. Objetivo: avaliar a cobertura vacinal para agentes causadores de infecções do trato respiratório e a prevalência de internações por essas afecções no Brasil no período de 2015 a 2020. Metodologia: trata-se de um estudo epidemiológico descritivo, cujos dados foram obtidos por meio do banco de dados proveniente do DATASUS, Sistema de Internação Hospitalar e Sistema de Informação do Programa Nacional de Imunizações. A seleção ocorreu por meio dos registros de indivíduos que foram imunizados no Brasil, por região e por ano de imunização das vacinas Pneumocócica, Pneumocócica 1º reforço, Tríplice viral D1, Tríplice viral 2, Tetra Viral, Pentavalente e Influenza. Resultados: ao decorrer dos anos, observou-se uma redução significativa da cobertura vacinal de todas as vacinas analisadas, com a região Norte apresentando o menor registro em todos os anos. Em relação a taxa de internações por pneumonia, a região Sudeste obteve as maiores taxas. Houve um aumento importante de internamentos por influenza na região Centro-Oeste em 2019. As taxas de internação por sarampo aumentaram significativamente no ano de 2018, principalmente na região Norte. Conclusão: apesar da redução progressiva nas taxas de cobertura vacinal das regiões brasileiras nos últimos anos, as taxas de internação para pneumonia e influenza tendem a queda, com aumento mais expressivo dos internamentos por sarampo no período analisado.


Introduction: respiratory airway infections are frequent infections. These infections are fought through use of antimicrobials, when indicated, and prophylaxis is done through immunization, reducing the incidence of infections and their complications. Objective: to evaluate vaccine coverage for agents responsible for respiratory tract infections and the prevalence of hospitalizations for these conditions in Brazil from 2015 to 2020. Methods: This is a descriptive epidemiological study. Data were obtained through the database from the Department of Informatics of SUS, Hospitalization System and Information System from the National Vaccination Program. Selection was conducted through analysis of the records of individuals who were vaccinated in Brazil, by region and by year of vaccination for the Pneumococcal and Pneumococcal 1st booster dose vaccines, first and second doses for Triple Viral vaccine, Tetra Viral vaccine, Pentavalent vaccine and influenza. Expected Results: over the years, there has been a significant reduction in vaccination coverage, with the Northern brazilian presenting the lowest record in all years. Regarding the rate of hospitalizations for pneumonia, the Southeastern had the highest rates. Assessing influenza, there was a more significant increase in the Midwest. Measles hospitalization rates increased significantly in 2018, especially North, despite disease eradication in 2016, with a parallel registry of reduction in vaccination coverage in the period analysed. Conclusion: Despite the progressive reduction in vaccination coverage rates in Brazilian in recent years, the hospitalization rates for pneumonia and influenza tend to fall, with a more expressive increase in hospitalizations for measles in the analyzed period.


Subject(s)
Humans , Respiratory Tract Diseases , Measles-Mumps-Rubella Vaccine , Vaccination Coverage , Hospitalization , Epidemiologic Studies , Epidemiology, Descriptive , Database
7.
Fisioter. Bras ; 23(1): 37-50, Fev 11, 2022.
Article in Portuguese | LILACS | ID: biblio-1358398

ABSTRACT

Introdução: As doenças crônicas são condições complexas de saúde associadas a sintomas variados, que aumentam a propensão a exacerbações, redução da capacidade funcional e piora da qualidade de vida (QV). Assim, restabelecer a capacidade funcional pode ser um importante alvo terapêutico, reduzindo a morbidade e a mortalidade. Para tal, torna-se necessária a monitorização dessa importante variável. Objetivo: Investigar a capacidade funcional de indivíduos com doenças crônicas. Métodos: Estudo transversal de amostra por conveniência com indivíduos adultos com doenças crônicas, o qual analisou o nível de capacidade funcional utilizando o Teste de Caminhada de 6 Minutos (TC6M) e o teste de sentar e levantar. A capacidade cardiorrespiratória por meio do questionário Duke Activity Status Index (DASI) e dispneia pelo Medical Research Council (MRC). Para avaliar o impacto da doença na vida do indivíduo, foi analisada a qualidade de vida (QV) pelo Questionário do Hospital Saint George na Doença Respiratória (SGRQ), o Questionário STOP-BANG para a detecção do risco de Síndrome Apneia Obstrutiva do Sono (SAOS) e para a avaliação da Sonolência Excessiva Diurna (SES) foi utilizado o questionário de Epworth. Os dados foram analisados no programa estatístico SigmaPlot versão 11.0 (Systat Software). Resultados: Foram estudados 77 indivíduos com doenças crônicas, sendo o principal diagnóstico a DPOC. A maior parte apresentou dispneia grau 2, aproximadamente 39% Sonolência Diurna e, aproximadamente, 25% alto risco de SAOS. A QV foi reduzida em todos os domínios, principalmente no domínio que analisou o impacto da doença na vida. A capacidade cardiorrespiratória foi baixa. A distância percorrida média no TC6m correspondeu a 72,72% do valor predito, demonstrando baixa capacidade funcional. Conclusão: Os indivíduos, com doenças crônicas, estudados apresentaram condições de saúde comprometidas de maneira multidimensional, com redução da capacidade funcional. Houve redução da qualidade de vida e da qualidade de sono, com a presença de distúrbio do sono em uma parcela significativa, além da presença de uma variedade de condições que repercutiram negativamente na sua vida. (AU)


Subject(s)
Quality of Life , Respiratory Tract Diseases , Sleep Apnea, Obstructive , Monitoring , Dyspnea , Walk Test , Disorders of Excessive Somnolence
8.
Fisioter. Bras ; 23(1): 128-151, Fev 11, 2022.
Article in Portuguese | LILACS | ID: biblio-1358609

ABSTRACT

Introdução: Envelhecer resulta em transformações biológicas que afetam os indivíduos de maneira heterogênea. A maioria dos sistemas orgânicos experimenta redução em suas funções motoras e cognitivas, interferindo na capacidade de adaptação frente a agentes estressores. Na pneumonia pelo SARS-CoV2, evidenciaram-se implicações da função pulmonar em idosos com doenças pulmonares crônicas. Objetivo: Investigar as evidências científicas sobre implicações clínicas da COVID-19 em indivíduos idosos com doença pulmonar crônica não transmissível. Métodos: revisão integrativa realizada em novembro de 2020 nas bases de dados CINAHL (Cumulative Index to Nursing and Allied Health Literature), Embase, Scopus, Medline/Pubmed (via National Library of Medicine) e Web of Science, utilizando-se os descritores "COVID-19", "SARS-CoV2 infection", "aged", "chronic pulmonar obstructive disease", "non-communicable diseases" e operadores booleanos AND e OR. Foram incluídos textos científicos originais, a exemplo de artigos disponibilizados na íntegra, sobre a COVID-19 em idosos com Doenças Respiratórias Crônicas Não Transmissíveis. Resultados: Idosos com comorbidades estão propensos a complicações durante a infecção por COVID-19, com altas taxas de mortalidade e alterações tomográficas atípicas. Conclusão: A forma grave da COVID-19 e a elevada mortalidade em idosos podem ser atribuídas à alta comorbidade, prevalência de demência e síndromes geriátricas. (AU)


Subject(s)
Aged , Aged, 80 and over , Pneumonia , Respiratory Tract Diseases , Comorbidity , Mortality , COVID-19 , Lung Diseases , Aged
9.
Curitiba; s.n; 20211220. 101 p. ilus, tab.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-1363965

ABSTRACT

Resumo: Introdução: As doenças respiratórias crônicas representam uma grande carga de invalidez e morte em todo o mundo. Esses problemas foram agravados pela pandemia COVID-19, aumentando a demanda por cuidados de enfermagem. Objetivo: Analisar as ações de enfermagem a pacientes com doenças respiratórias crônicas, associadas à infecção por COVID-19. Método: Estudo observacional, descritivo e retrospectivo com percurso longitudinal, realizado em um hospital de referência para COVID-19 em um município da região sul do Brasil. A fonte de dados foram 42 prontuários eletrônicos de pacientes com doenças respiratórias crônicas e infecção por COVID-19, internados entre março de 2020 e fevereiro de 2021. A coleta de dados foi feita por meio de um formulário com questões referentes à situação sociodemográfica e clínica dos pacientes, e as ações de enfermagem, feitas de acordo com as taxonomias Diagnósticos de enfermagem da North American Nursing Diagnosis Association International (NANDA-I), Classificação de Resultados de Enfermagem (NOC) e Classificação de Intervenções de Enfermagem (NIC). As variáveis foram agrupadas, categorizadas e analisadas descritivamente de acordo com sua distribuição. Resultados: Em relação ao perfil sociodemográfico, a proporção entre homens e mulheres foi equitativa com razão de 1:1, a idade média dos pacientes foi de 56,5 anos, 57,1% deles entre 40 e 69 anos e 85,7% residindo em zona urbana. Em relação ao quadro clínico, a doença crônica prevalente foi a asma (61,9%), seguida da hipertensão arterial (59,5%). Apesar de menos da metade dos pacientes necessitarem de internação em Unidade de Terapia Intensiva (40,4%), observou-se alta mortalidade (58,8%) entre eles, predominantemente em mulheres (60%) com idade superior a 60 anos. A hipertensão foi encontrada em 100% dos falecidos, assim como outras doenças cardiovasculares (70%), asma, DPOC e diabetes foram encontrados na mesma proporção (50%). Em relação às ações de enfermagem, 16 diagnósticos segundo a taxonomia NANDA-I e 48 intervenções segundo a taxonomia NIC foram descritos pelos profissionais de enfermagem nos registros, a maioria deles voltada à identificação, controle e redução de problemas respiratórios e/ou derivados da infecção, bem como à prevenção de possíveis riscos. Nenhuma descrição dos resultados foi encontrada de acordo com a taxonomia NOC. Conclusões: Constatou-se que as ações de enfermagem para o cuidado às pessoas com doenças respiratórias acometidas pelo COVID-19 estão voltadas para o tratamento e controle dos sintomas respiratórios e do processo infeccioso. Em relação às intervenções de enfermagem, a maioria foi direcionada à dimensão fisiológica. Os resultados deste estudo evidenciam a importância da prática de enfermagem no contexto da pandemia COVID-19 no cuidado às pessoas com doenças respiratórias crônicas, oferecendo uma visão da variedade de atividades desenvolvidas pelos profissionais de enfermagem durante o processo assistencial.


Abstract: Introduction: Chronic respiratory diseases represent a high burden of disability and death worldwide. These problems were exacerbated by the COVID-19 pandemic, increasing the demand for nursing care. Objective: To analyze the nursing actions for patients with chronic respiratory diseases associated with COVID-19 infection. Method: Observational, descriptive and retrospective study with a longitudinal course, developed in a reference hospital for COVID-19 in a city in southern Brazil. The data source was 42 electronic medical records of patients with chronic respiratory diseases and COVID-19 infection, hospitalized between March 2020 to February 2021. Data collection was carried out using a form that consists of information on the sociodemographic and clinical profile of the patients, and the main nursing actions carried out according to the North American Nursing Diagnosis Association International (NANDA-I), the Nursing Outcomes Classification (NOC) and the Nursing Intervention Classification (NIC) taxonomies. The variables were grouped and categorized into sociodemographic, clinical, and those related to nursing actions to later be analyzed descriptively according to their distribution. Results: In relation to the sociodemographic profile, the proportion between men and women was equitable with a ratio of 1:1, the average age of the patients was 56.5 years with 57.1% of these between 40 and 69 years and 85, 7% residing in the urban area. Regarding the clinical profile, the most prevalent chronic disease was Asthma (61.9%), followed by Hypertension (59.5%). Although less than half of the patients required hospitalization in the Intensive Care Unit (40.4%), a high mortality rate (58.8%) among them was observed, predominantly in women (60.0%) older than 60 years. Hypertension was found in 100% of the deceased, as well as other cardiovascular diseases (70.0%), asthma, COPD and diabetes were found in the same proportion (50.0%). Regarding nursing actions,16 diagnoses according to the NANDA-I taxonomy and 48 interventions according to the NIC taxonomy were described by the nursing professionals in the registries, most of them aimed at the identification, control and reduction of respiratory problems and / or those derived from infection, as well as the prevention of possible risks. No description of results was found according to the NOC taxonomy. Conclusions: It was found that nursing actions for the care of people with respiratory diseases affected by COVID-19 are mainly focused on the treatment and control of respiratory symptoms and the infectious process. Regarding nursing interventions, most were directed to the physiological dimension. The results of this study highlight the importance of nursing practice in the context of the COVID-19 pandemic, especially in the care of people with chronic respiratory diseases, offering a vision of the great variety of activities developed by the nursing professionals during the caring process.


Resumen: Introducción: Las enfermedades respiratorias crónicas representan una alta carga de discapacidad y muerte a nivel mundial. Estos problemas fueron agravados por la pandemia de COVID-19, aumentando la demanda de cuidados de enfermería. Objetivo: Analizar las acciones de enfermería para pacientes con enfermedades respiratorias crónicas asociadas a la infección por COVID-19. Método: se trata de un estudio observacional, descriptivo y retrospectivo de curso longitudinal, realizado en un hospital de referencia para COVID-19 en un municipio de la región sur de Brasil. La fuente de datos fueron 42 historias clínicas electrónicas de pacientes portadores de enfermedades respiratorias crónicas e infección por COVID-19, hospitalizados entre el periodo de marzo de 2020 a febrero de 2021. La recolección de los datos se realizó por medio de un formulario que consta de informaciones sobre el perfil sociodemográfico, clínico de los pacientes y las principales acciones de enfermería realizadas según las taxonomías Diagnósticos de enfermería de la North American Nursing Diagnosis Association International (NANDA-I), Clasificación de los Resultados de Enfermería (NOC) e Clasificación de las Intervenciones de Enfermería (NIC). Las variables fueron agrupadas y categorizadas en sociodemográficas, clínicas y las relacionadas con las acciones de enfermería para posteriormente ser analizadas de forma descriptiva según su distribución. Resultados: En relación al perfil sociodemográfico, la proporción entre hombres y mujeres fue equitativa con una razón de 1:1, la edad promedio de los pacientes fue de 56,5 años con 57,1% de estos entre los 40 y 69 años, y 85,7% residiendo en el área urbana. Al respecto del perfil clínico, la enfermedad crónica más prevalente fue el Asma (61,9%), seguida por la Hipertensión arterial (59,5%), Aunque menos de la mitad de los pacientes requirió de internación en la Unidad de Terapia Intensiva (40,4%), una alta mortalidad (58,8%) fue observada entre estos, predominantemente en mujeres (60,0%) con edad mayor a 60 años. Se encontró hipertensión en el 100% de los fallecidos, así como otras enfermedades cardiovasculares (70,0%), el asma, la EPOC y la diabetes se encontraron en igual proporción (50,0%). En cuanto a las acciones de enfermería, 16 diagnósticos según la taxonomía NANDA-I y 48 intervenciones según la taxonomía NIC fueron descritas por los profesionales de enfermería en los registros, siendo la mayoría orientadas a la identificación, control y disminución de problemas respiratorios y/o derivados de la infección, así como la prevención de posibles riesgos. No se encontró descripción de resultados de acuerdo a la taxonomía NOC. Conclusiones: Se encontró que las acciones de enfermería para el cuidado de personas con enfermedades respiratorias afectadas por COVID-19 se enfocan principalmente en el tratamiento y control de los síntomas respiratorios y el proceso infeccioso. En cuanto a las intervenciones de enfermería, la mayoría se dirigieron a la dimensión fisiológica. Los resultados de este estudio destacan la importancia de la práctica de enfermería en el contexto de la pandemia por COVID-19, en especial en la atención a personas con enfermedades respiratorias crónicas, ofreciendo una visión de la gran variedad de actividades desarrolladas por los profesionales de enfermería durante el proceso de cuidar.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Respiratory Tract Diseases , Coronavirus , COVID-19 , Nursing Care
10.
Rev. Méd. Inst. Mex. Seguro Soc ; 59(6): 482-489, 01-dic-2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1354788

ABSTRACT

Introducción: el SARS-CoV-2 es un coronavirus que fue descrito por primera vez en diciembre de 2019 en Wuhan, China. Este virus causa una enfermedad que varía en un espectro de severidad que va desde casos asintomáticos hasta defunciones. Los casos más severos se asocian normalmente con algunas comorbilidades y con la edad del paciente. Sin embargo, existen pacientes que no son parte de estos grupos de riesgo y aun así desarrollan casos graves. Objetivo: determinar la asociación entre las coinfecciones por SARS-CoV-2 y otros virus respiratorios y su desenlace clínico. Material y métodos: se realizó RT-qPCR para determinar la presencia de 16 virus respiratorios en 103 casos confirmados de COVID-19. Se recolectaron datos demográficos y de comorbilidades, y se realizaron análisis estadísticos para determinar asociaciones con gravedad. Resultados: el 13.6% de los casos (14/103) presentaron alguna coinfección, de estos, el 92% nunca requirió ingreso hospitalario, aun en aquellos casos en los que el paciente presentara comorbilidades y edad avanzada. Conclusiones: estos resultados sugieren que la coinfección no está relacionada con un COVID-19 más grave y que, dependiendo del virus involucrado, incluso podría conducir a un mejor pronóstico. Estos hallazgos sientan las bases para nuevos estudios dirigidos a determinar el mecanismo biológico por el cual ocurre este fenómeno y a proponer las estrategias correspondientes para limitar la progresión a casos severos de COVID-19.


Background: SARS-CoV-2 is a coronavirus described for the first time in China, in December 2019. This virus can cause a disease with a very variable spectrum that ranges from asymptomatic cases to deaths. The most severe cases are normally associated with comorbidities and with the age of the patient. However, there are patients who are not part of these risk groups and develop severe cases. Objetive: To determine the association between coinfections by SARS-CoV-2 and other respiratory viruses and their clincal outcome. Material and methods: RT-qPCR was performed to determine the presence of 16 respiratory viruses in 103 confirmed COVID-19 cases. Demographic and comorbid data were collected, and statistical analyzes were performed to determine associations with severity. Results: Of the 103 analyzed cases, 14 (13.6%) presented a coinfection, of these, 92% did not require hospitalization, even in those cases in which the patient presented advanced age and some comorbidities. Conclusions: These results suggest that coinfection of SARS-CoV-2 and other respiratory viruses is not related to a more severe form of COVID-19 and, in some cases, depending on the virus involved, it could even lead to a better prognosis. These findings lay the foundations for the development of new studies that could determine the biological mechanism of this phenomenon.


Subject(s)
Humans , Male , Female , Respiratory Tract Diseases , Coinfection , SARS-CoV-2 , COVID-19 , Prognosis , Risk Groups , Demographic Data , Health Strategies
11.
Rev. bras. ciênc. vet ; 28(4): 198-205, out./dez. 2021.
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1363471

ABSTRACT

Os cães idosos são acometidos com frequência por enfermidades no sistema cardiovascular e respiratório, estando muita das vezes assintomáticos até terem indicação para algum procedimento cirúrgico que requer a avaliação pré-operatória, momento este que muitos achados clínicos poderão ser detectados, ao ponto da necessidade de tratamento prévio à intervenção cirúrgica. Diante disso, o trabalho tem por objetivo detectar as principais manifestações cardiorrespiratórias e sua correlação aos dados encontrados nos exames complementares e informações epidemiológicas de 138 cães atendidos em um serviço especializado em cardiologia e doenças respiratórias, no período de 2017 a 2021, para fins de risco cirúrgico. Foi possível observar maior predominância de animais idosos, de pequeno porte e do sexo feminino. Dentre as doenças cardíacas, a doença degenerativa crônica de mitral foi a mais prevalente, seguida da dirofilariose. Em relação as afecções respiratórias, a bronquite crônica e o colapso de traqueia foram mais diagnosticadas, seguidas da broncopneumonia e da síndrome braquicefálica. Quando da observação do ritmo cardíaco por meio do eletrocardiograma, a arritmia sinusal, ritmo sinusal e sinus arrest foram os principais achados. Quanto aos achados laboratoriais, foi possível observar aumento da média de hematimetria, redução da média do hematócrito e das plaquetas. Entretanto, alguns animais apresentaram azotemia, leucocitose e eosinofilia. Observou-se que pacientes com doenças cardíacas em estágios de congestão possuem redução da pressão arterial, aumento da hematimetria e taquiarritmias, como taquicardia sinusal e/ou complexos atriais prematuros. Pacientes com idade mais avançada tendem a ter redução dos valores de leucometria global e maior probabilidade de manifestação de aumento da pressão arterial. Portadores de dirofilariose cursam com aumento de eosinófilos.


Elderly dogs are frequently affected by diseases in the cardiovascular and respiratory system, being often asymptomatic until they are indicated for a surgical procedure that requires preoperative evaluation, at which point many clinical findings can be detected, to the point of need for treatment prior to surgical intervention. Therefore, the work aims to detect the main cardiorespiratory manifestations and their correlation to data found in complementary exams and demographic information of 138 animals treated at a service specialized in cardiology and respiratory diseases, from 2017 to 2021, for risk purposes surgical. It was possible to observe a greater predominance of elderly, small and female animals. Among heart diseases, chronic degenerative mitral disease was the most prevalent, followed by heartworm disease. Regarding respiratory affections, chronic bronchitis and tracheal collapse were more commonly diagnosed, followed by bronchopneumonia and brachycephalic syndrome. When observing the cardiac rhythm through the electrocardiogram, sinus arrhythmia, sinus rhythm and sinus arrest were the main findings. As for laboratory findings, it was possible to observe an increase in mean hematimetry, a reduction in mean hematocrit and platelets. However, some animals showed azotemia, leukocytosis and eosinophilia. It was observed that patients with cardiac diseases in stages of congestion have reduced blood pressure, increased hematimetry and tachyarrhythmias, such as sinus tachycardia and/or premature atrial complexes. Older patients tend to have reduced global white blood cell values and more likely to manifest increased blood pressure. Heartworm patients have an increase in eosinophils.


Subject(s)
Animals , Dogs , Respiratory Tract Diseases/veterinary , Cardiovascular Diseases/veterinary , Dog Diseases , Heart Diseases/veterinary
12.
Edumecentro ; 13(3): 426-430, jul.-sept. 2021.
Article in Spanish | MTYCI, LILACS, MTYCI | ID: biblio-1283607

ABSTRACT

Las enfermedades respiratorias infecciosas afectan con frecuencia a los pacientes que acuden a consultas; constituyen una de las más incapacitantes e incluso, si no se atienden adecuadamente generan una evolución tórpida y pueden comprometer la vida del paciente. En su tratamiento se emplean medicamentos alopáticos, así como modalidades terapéuticas de medicina natural y tradicional. Teniendo en cuenta el desarrollo de la homeopatía en Cuba en los últimos años, se propone como objetivo enfatizar en la importancia de la superación por parte de los profesionales de la salud en el uso de esta modalidad terapéutica, a fin de utilizarla en los diferentes niveles de atención por su pertinencia en tiempos de pandemia.


Infectious respiratory diseases frequently affect patients who attend consultations; they constitute one of the most incapacitating and even, if they are not taken care properly they generate a torpid evolution and can jeopardize the life of the patient. In its treatment allopathic medications are used, as well as therapeutic modalities of herbal and folk medicine. Taking into account the development of homeopathy in Cuba in recent years, it is proposed as an objective to emphasize the importance of improvement by health professionals in the use of this therapeutic modality, in order to use it at different levels of care for its relevance in times of pandemic.


Subject(s)
COVID-19 , Homeopathy , Respiratory Tract Diseases , Cuba , Medicine, Traditional
13.
Cambios rev. méd ; 20(1): 74-79, 30 junio 2021.
Article in Spanish | LILACS | ID: biblio-1292925

ABSTRACT

INTRODUCCIÓN. Para el tratamiento farmacoterapéutico de enfermedades respi-ratorias, el uso de herramientas para abordar la vía inhalatoria es de elección por su mayor eficacia y menos efectos secundarios; registrar su adhesión y prevalencia es importante. OBJETIVO. Determinar el nivel y la prevalencia de adhesión al uso de inhaladores en pacientes con Asma y Enfermedad Pulmonar Obstructiva Cróni-ca. MATERIALES Y MÉTODOS. Estudio analítico transversal. Población de 215 y muestra de 121 Historias Clínicas. Se aplicó el Test de Adhesión a Inhaladores, que consistió en dos cuestionarios complementarios: el de 10 ítems, que valoró el nivel de adhesión, y el de 12 que identificó el tipo de incumplimiento en pacientes de Consulta Externa de la Unidad Técnica de Neumología del Hospital de Especialidades Carlos Andrade Marín, periodo julio 2018 - enero 2019. La tabulación y análisis de datos se realizó con el programa Excel. RESULTADOS. La prevalencia de mala adhesión en asmáticos fue de 83,33% y en Enfermedad Pulmonar Obstructiva Crónica 13,33%. En cuanto al sexo, la prevalencia de mala adhesión fue de 15,28% en hombres y de 40,82% en mujeres, con una p<0,05. No se encontró diferencia significativa respecto a los niveles de instrucción. CONCLUSIÓN. La prevalencia de mala adhesión al uso de inhaladores en pacientes con Asma y Enfermedad Pulmonar Obstructiva Crónica fue alta sobre todo en los asmáticos.


INTRODUCTION. For respiratory diseases and their pharmacotherapeutic treatment, the use of tools to address the inhalation route is chosen due to its greater efficacy and fewer secondary effects; then record the adherence and prevalence is important. OBJECTIVE. To determine both level and prevalence of adherence to the use of inhalers in patients with Asthma and Chronic Obstructive Pulmonary Disease. MATE-RIALS AND METHODS. Cross-sectional analytical study. Population of 215 and sam-ple of 121 patients. The Inhaler Adherence Test was applied, which consisted of two complementary questionnaires: a 10-item questionnaire, which assessed the level of adherence, and a 12-item questionnaire that identified the type of non-compliance in patients of the Pneumology Technical Unit of the Hospital de Especialidades Carlos Andrade Marín, period July 2018 - January 2019. The tabulation and data analysis was performed with Microsoft Excel program. RESULTS. The prevalence of poor ad-herence in asthmatics was 83.33% and in Chronic Obstructive Pulmonary Disease was 13.3%. Regarding gender, the prevalence of poor adherence was 15.28% in men and 40.82% in women, with a p <0.05. No significant differences were found regarding the levels of instruction. CONCLUSION. The prevalence of poor adherence to the use of inhalers in patients with Asthma and Chronic Obstructive Pulmonary Disease was high, especially in asthmatics


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Respiratory Tract Diseases , Asthma , Nebulizers and Vaporizers , Pulmonary Medicine , Pulmonary Disease, Chronic Obstructive , Treatment Adherence and Compliance , Respiratory Therapy , Bronchodilator Agents , Medication Therapy Management , Medication Adherence , Dry Powder Inhalers
14.
Biomédica (Bogotá) ; 41(1): 168-178, ene.-mar. 2021. graf
Article in Spanish | LILACS | ID: biblio-1249069

ABSTRACT

Resumen | Introducción. La legionelosis es una enfermedad respiratoria bacteriana de origen ambiental que puede ser adquirida en el ámbito comunitario u hospitalario, y suele estar asociada con equipos, instalaciones y edificios. La forma clínica más conocida es la neumónica, conocida como enfermedad del legionario. Objetivo. Determinar la evolución de los casos de legionelosis en España en el periodo de 2010 a 2015. Materiales y métodos. Se hizo un estudio descriptivo de series temporales y se analizaron los casos de legionelosis notificados al Centro Nacional de Epidemiología del Gobierno de España. Se determinó la distribución de los casos según el sexo, la comunidad autónoma, el mes y los grupos de edad. Para el último se diferenció entre hombres y mujeres. Resultados. El recuento de casos en hombres fue superior al doble con respecto a las mujeres. La distribución en las comunidades autónomas presentó un aumento de los casos notificados al final del periodo en nueve de ellas, siendo notable en Castilla y León, Navarra y el País Vasco, y muy relevante en Castilla-La Mancha. Se estableció un patrón estacional con un pico epidémico en julio-septiembre y un mayor número de casos en torno a los 50 años de edad en ambos sexos. Conclusiones. A pesar de mostrar una prevalencia baja con respecto a otras enfermedades respiratorias, la legionelosis tiene gran impacto en la salud pública. Presenta una distribución global y heterogénea en el territorio español, con un aumento de casos en los dos últimos años, por lo que se requiere una mejor prevención y control de la enfermedad.


Abstract | Introduction: Legionellosis is a bacterial respiratory disease with an environmental origin in the community or in hospitals; it is usually associated with devices, facilities, and buildings. The most common clinical form is the pneumonic, known as legionnaires' disease. Objective: To determine the evolution of legionellosis cases in Spain from 2010 to 2015. Materials and methods: This was a descriptive study of time series with an analysis of the legionellosis cases notified to the Centro Nacional de Epidemiología (Government of Spain). Case distribution was determined according to sex, the autonomous community of origin, month, and age groups differentiating in the latter between men and women. Results: Case count in men was more than double compared to that in women. The cases notified by nine of the autonomous communities showed an increase at the end of the period, especially in Castilla y León, Navarra, and the Basque Country but also notable in Castilla-La Mancha. A seasonal pattern was identified with an epidemic peak in July-September and a greater number of cases among 50-years old people from both sexes. Conclusion: Despite its low prevalence compared to other respiratory diseases, legionellosis has a great impact on public health. Its distribution in Spain is global and heterogeneous with cases increasing in the last two years. Therefore, better disease prevention and control measures are recommended.


Subject(s)
Legionellosis/epidemiology , Pneumonia , Respiratory Tract Diseases , Spain , Case Reports
15.
Rev. epidemiol. controle infecç ; 11(1): 12-18, jan.-mar. 2021. ilus
Article in English | LILACS | ID: biblio-1362018

ABSTRACT

Background and objectives: Respiratory diseases affect all age groups and pose a high demand on health services. The present study aimed to analyze the profile of patients who have died from respiratory diseases, between 2006 and 2015, from the 9th Health Coordination of Rio Grande do Sul. Methods: This is a cross-sectional and descriptive study using the database of the Informatics Department of the Unified Health System (Datasus) from the Ministry of Health in Brazil. Data collection was carried out in November 2017 and included 10 years up to 2015. The causes of death from respiratory disease were selected according to the International Classification of Diseases 10th revision, Chapter X, vital statistics, mortality from 1996 to 2015. The variables for this research were collected according to chronological distribution, gender, age and period of the year. Results: Out of a total of 1,471 deaths from respiratory diseases, 52% were men, most were older adults (61%) with up to 3 years of education (73.3%), which is possibly associated with low income. The main causes of death were chronic diseases of the lower airways and pneumonia, representing 56% and 29% of deaths, respectively. In addition, 34% of deaths occurred during winter. Conclusion: The main causes of mortality from respiratory diseases from the 9th Health Coordination were chronic diseases of the lower airways and pneumonia, with higher mortality rates in colder months, among older adults and patients with a lower level of education.(AU)


Justificativa e objetivos: As doenças respiratórias atingem todas as faixas etárias e geram grande demanda dos serviços de saúde. O presente estudo objetivou analisar o perfil dos óbitos por doenças respiratórias na 9ª Coordenadoria de Saúde do Rio Grande do Sul, entre 2006 e 2015. Métodos: Trata-se de um estudo transversal e descritivo em que se utilizou o banco de dados do Departamento de Informática do Sistema Único de Saúde (Datasus) do Ministério da Saúde do Brasil. A coleta de dados foi realizada em novembro de 2017, abrangendo os últimos 10 anos. A seleção das causas de óbitos por doenças respiratórias foi selecionada de acordo com o Código Internacional de Doenças 10ª revisão, Capítulo X, estatísticas vitais, mortalidade de 1996 a 2015. As variáveis para esta pesquisa foram coletadas de acordo com a distribuição cronológica, sexo, idade e período do ano do óbito. Resultados: Do total de 1.471 óbitos por doença respiratória, observou-se que 52% acometeram homens, na maioria idosos (61%) e com até 3 anos de estudo (73%), o que pressupõe baixa renda. As principais causas de óbitos foram as doenças crônicas das vias aéreas inferiores e pneumonia, equivalendo a 56% e 29% dos óbitos respectivamente, sendo 34% dos óbitos ocorridos durante o inverno. Conclusão: As principais causas de mortalidade por doenças respiratórias ocorridas na 9ª Coordenadoria de Saúde foram as doenças crônicas das vias aéreas inferiores e pneumonia, com maior ocorrência nos meses mais frios, acometendo mais homens idosos e com menor nível escolar.(AU)


Justificación y objetivos: Las enfermedades respiratorias afectan a todas las edades y generan gran demanda por los servicios de salud. El presente estudio objetiva analizar el perfil de las muertes por enfermedades respiratorias en la 9ª Coordinación de Salud del Rio Grande do Sul, entre 2006 y 2015. Métodos: Se trata de un estudio transversal descriptivo con base en informaciones del Departamento de Informática del Sistema Único de Salud (Datasus) del Ministerio de la Salud (Brasil). La recolección de datos se realizó en noviembre de 2017, abarcando los últimos 10 años. La selección de las causas de muertes por enfermedades respiratorias fue estimada seguido la Clasificación Internacional de Enfermedades 10ª Revisión, Capítulo X, estadísticas vitales, mortalidad de 1996 a 2015. Las variables para esta investigación fueron recolectadas de acuerdo con la distribución cronológica, sexo, edad y período del año del óbito. Resultados: De las 1.471 muertes por enfermedad respiratoria, fue observado que 52% en hombres (767), la mayoría ancianos (61%), hasta 3 años de estudio (73%,) o que presupone bajos ingresos. Las principales causas de muerte fueron las enfermedades crónicas de las vías aéreas inferiores y la neumonía, equivalente al 56% y 29% de los casos, respectivamente, el 34% de las muertes ocurrieron durante el invierno. Conclusiones: Las principales causas de mortalidad por enfermedades respiratorias ocurridas en la 9ª Coordinación de Salud en los 10 años fueron enfermedades crónicas de las vías aéreas inferiores y neumonía, con mayor ocurrencia en los meses más fríos, afectando más hombres ancianos con menor nivel escolar.(AU)


Subject(s)
Humans , Respiratory Tract Diseases/mortality , Respiratory Tract Diseases/epidemiology , Mortality Registries
16.
Arch. med ; 21(1): 266-278, 2021/01/03.
Article in Spanish | LILACS | ID: biblio-1148455

ABSTRACT

La pandemia COVID-19 ha causado grandes estragos en los sistemas de salud a nivel mundial. Desde la fisioterapia respiratoria, se propende por realizar intervenciones costo-efectivas basadas en la mejor evidencia disponible, para minimizar los efectos funcionales en dichos pacientes con COVID-19. Por ello, se revisó la literatura para cimentar una revisión teórica desde la funcionalidad en lo relacionado a la fisioterapia respiratoria frente a la pandemia. Los resultados incluyeron publicaciones y guías de manejo en español, inglés y portugués acerca de las acciones de los diferentes países frente a los compromisos funcionales que repercuten en la calidad de vida de estos pacientes. Se concluyó que la fisioterapia respiratoria aplica protocolos de intervención efectos en el COVID-19 para la mitigación de complicaciones físico y funcionales que mejoran la calidad de vida de los pacientes..Au


The COVID-19 pandemic has wreaked great havoc on health systems globally. From respiratory physiotherapy, it tends to carry out cost-effective interventions based on the best available evidence, to minimize the functional effects in said patients with COVID-19. For this reason, the literature was reviewed to establish a theoretical review from the functionality in relation to respiratory physiotherapy in the face of the pandemic. The results included publications and management guides in Spanish, English and Portuguese about the actions of the different countries in the face of functional compromises that affect the quality of life of these patients. It was concluded that respiratory physiotherapy applies intervention protocols effects in COVID-19 for the mitigation of physical and functional complications that improve the quality of life of patients..Au


Subject(s)
Humans , Respiratory Tract Diseases , Coronavirus Infections , Physical Therapy Specialty
17.
Article in Chinese | WPRIM | ID: wpr-921713

ABSTRACT

This study investigated the material basis and mechanism of Pinelliae Rhizoma Decoction in the treatment of airway inflammation. The cigarette smoke combined with lipopolysaccharide(LPS) was used to induce an airway inflammation model in mice. The expression levels of IL-6 and IL-8 in the bronchoalveolar lavage fluid(BALF) and the phosphorylation levels of p38 and IκB in the lungs of mice were taken as indexes to screen the effective extracts by system solvent extraction from Pinelliae Rhizoma Decoction(dichloromethane extract, ethyl acetate extract, n-butanol extract, etc.). Meanwhile, the human bronchial epithelial(16-HBE) cell model of cigarette smoke extract(CSE)-induced injury was established, and the mRNA expression levels of IL-6 and IL-8 and the phosphorylation levels of p38 and IκB proteins were also taken as indexes to evaluate the anti-inflammatory effect of different extracts of Pinelliae Rhizoma Decoction. The results showed that Pinelliae Rhizoma Decoction significantly antagonized airway inflammation in mice by down-regulating the expression levels of IL-6 and IL-8 in mice with airway inflammation and 16-HBE cells with CSE-induced injury and inhibiting the phosphorylation levels of p38 and IκB. The dichloromethane and ethyl acetate extracts of Pinelliae Rhizoma Decoction showed significant anti-inflammatory effects, while such effects of other extracts were not prominent. Furthermore, the database of Pinelliae Rhizoma composition was constructed, and the components in effective extracts were analyzed by HPLC-TOF-MS and Nano-LC-MS/MS. As revealed by the results, the compositions of the two effective extracts were similar with 36 common components. They were combined and then divided into Pinelliae Rhizoma alkaloids(PTAs) and Pinelliae Rhizoma non-alkaloids(PTNAs) by 732 cation-exchange resin. Further in vitro investigation confirmed the significant anti-inflammatory effect of PTNAs, while such effect of PTAs was not manifest. The MS analysis showed 172 peptides and 7 organic acids in PTNAs. The peptide content in PTNAs was 63.5% measured by quantitative analysis of BCA assay, and the organic acid content was 9.92% by potentiometric titration method. The findings of this study suggested that Pinelliae Rhizoma Decoction could antagonize airway inflammation in mice by inhibiting phosphorylation of p38 and IκB and blocking the activation of MAPK and NF-κB signaling pathways, and the effective components were related to the peptides and organic acids in PTNAs. The above results lay a foundation for the research on the mechanism and material basis of Pinelliae Rhizoma in antagonizing airway inflammation.


Subject(s)
Animals , Drugs, Chinese Herbal/pharmacology , Inflammation/drug therapy , Mice , NF-kappa B/genetics , Pinellia/chemistry , Respiratory Tract Diseases/drug therapy , Rhizome , Tandem Mass Spectrometry
18.
Acta sci. vet. (Impr.) ; 49: Pub. 1838, 2021. tab
Article in English | LILACS, VETINDEX | ID: biblio-1363604

ABSTRACT

Respiratory diseases are one of the major health issues described in intensive pig production, causing important economic losses. However, there is little information on the prevalence, etiology and clinical-pathological presentation of these diseases in wild boars. For this reason, this work investigated the presence in captive wild boars of pneumonic lesions and bacterial pathogens commonly detected and associated with respiratory diseases in domestic pigs. A total of 226 captive wild boar lungs from two farms were examined in a slaughterhouse in Southern Brazil. The pneumonic lesions were classified as cranioventral, dorsocaudal, and disseminated, and the quantification of lesions was calculated. From the total of 226 lungs, 121 were collected for laboratory examination. Lungs with macroscopic lesions suggestive of pneumonia were collected for histological, bacteriological and molecular analysis. The molecular analysis was performed to detect the presence of Actinobacillus (A.) pleuropneumoniae, Glaesserella (G.) parasuis, Mycoplasma (M.) hyopneumoniae, Mycoplasma (M.) hyorhinis and Streptococcus (S.) suis serotype 2. The percentages of histological lesions and bacterial agents and their association were calculated. Cranioventral consolidation (75.2%) was the most prevalent macroscopic lung lesion, followed by disseminated (21.5%) and dorsocaudal (3.3%) distribution. Microscopically, chronic lesions were the most prevalent, representing 70.2% of the lungs. Moreover, BALT hyperplasia was present in 86.5% of the lungs, suppurative bronchopneumonia in 65.7%, and alveoli infiltrate in 46.8%. Six bacterial pathogens commonly described as agents of pig pneumonia were identified by bacterial or molecular methods: Pasteurella (P.) multocida, S. suis, M. hyopneumoniae, A. pleuropneumoniae, G. parasuis and M. hyorhinis. Twenty-eight different combinations of pathogens were identified in 84 samples (69.4%). The most common combinations were: M. hyopneumoniae and A. pleuropneumoniae (13.1%), M. hyopneumoniae, G. parasuis and M. hyorhinis (10.7%), and M. hyopneumoniae, A. pleuropneumoniae and G. parasuis (8.3%). Additionally, M. hyopneumoniae was the most frequent pathogen detected in this study, representing 58.7% of the samples. The detection of M. hyopneumoniae and M. hyorhinis by PCR was associated with the presence of BALT hyperplasia (P < 0.05) and there was also an association between the detection of M. hyopneumoniae by PCR and suppurative bronchopneumonia (P < 0.05). In addition, a significant association (P < 0.05) between the detection of M. hyopneumoniae and A. pleuropneumoniae by PCR and the histological classification (acute, subacute or chronic lesions) was observed. The results of this study were similar to those observed in slaughtered domestic pigs, although, the detection of opportunist pathogens was less frequent than that usually described in pig pneumonia. The high prevalence of pneumonia in captive wild boars at slaughter and the similar characteristics of pneumonia in captive wild boars and domestic pigs suggest that the close phylogenetic relationship between pigs and wild boars could influence the susceptibility of both species to the colonization of the same pathogens, indicating that captive wild boars raised in confined conditions could be predisposed to respiratory diseases, similar to domestic pigs.(AU)


Subject(s)
Animals , Respiratory Tract Diseases/veterinary , Sus scrofa/physiology , Pneumonia of Swine, Mycoplasmal/diagnosis , Pneumonia of Swine, Mycoplasmal/etiology , Lung Injury/veterinary , Lung/pathology
19.
Article in English | WPRIM | ID: wpr-888606

ABSTRACT

BACKGROUND@#Particulate matter (PM), a major component of ambient air pollution, accounts for a substantial burden of diseases and fatality worldwide. Maternal exposure to PM during pregnancy is particularly harmful to children's health since this is a phase of rapid human growth and development.@*METHOD@#In this review, we synthesize the scientific evidence on adverse health outcomes in children following prenatal exposure to the smallest toxic components, fine (PM@*RESULTS@#Maternal exposure to fine and ultrafine PM directly and indirectly yields numerous adverse birth outcomes and impacts on children's respiratory systems, immune status, brain development, and cardiometabolic health. The biological mechanisms underlying adverse effects include direct placental translocation of ultrafine particles, placental and systemic maternal oxidative stress and inflammation elicited by both fine and ultrafine PM, epigenetic changes, and potential endocrine effects that influence long-term health.@*CONCLUSION@#Policies to reduce maternal exposure and health consequences in children should be a high priority. PM


Subject(s)
Adult , Air Pollutants/adverse effects , Air Pollution/prevention & control , Animals , Cardiovascular Diseases/chemically induced , Child Health , Child, Preschool , Disease Models, Animal , Endocrine System Diseases/chemically induced , Epigenomics , Female , Humans , Immune System Diseases/chemically induced , Infant , Infant, Newborn , Male , Maternal Exposure/adverse effects , Nervous System Diseases/chemically induced , Oxidative Stress , Particle Size , Particulate Matter/adverse effects , Placenta , Pregnancy , Pregnancy Outcome/epidemiology , Prenatal Exposure Delayed Effects/epidemiology , Respiratory Tract Diseases/chemically induced , Young Adult
20.
Article in English | WPRIM | ID: wpr-888604

ABSTRACT

BACKGROUND@#Ambient temperature may contribute to seasonality of mortality; in particular, a warming climate is likely to influence the seasonality of mortality. However, few studies have investigated seasonality of mortality under a warming climate.@*METHODS@#Daily mean temperature, daily counts for all-cause, circulatory, and respiratory mortality, and annual data on prefecture-specific characteristics were collected for 47 prefectures in Japan between 1972 and 2015. A quasi-Poisson regression model was used to assess the seasonal variation of mortality with a focus on its amplitude, which was quantified as the ratio of mortality estimates between the peak and trough days (peak-to-trough ratio (PTR)). We quantified the contribution of temperature to seasonality by comparing PTR before and after temperature adjustment. Associations between annual mean temperature and annual estimates of the temperature-unadjusted PTR were examined using multilevel multivariate meta-regression models controlling for prefecture-specific characteristics.@*RESULTS@#The temperature-unadjusted PTRs for all-cause, circulatory, and respiratory mortality were 1.28 (95% confidence interval (CI): 1.27-1.30), 1.53 (95% CI: 1.50-1.55), and 1.46 (95% CI: 1.44-1.48), respectively; adjusting for temperature reduced these PTRs to 1.08 (95% CI: 1.08-1.10), 1.10 (95% CI: 1.08-1.11), and 1.35 (95% CI: 1.32-1.39), respectively. During the period of rising temperature (1.3 °C on average), decreases in the temperature-unadjusted PTRs were observed for all mortality causes except circulatory mortality. For each 1 °C increase in annual mean temperature, the temperature-unadjusted PTR for all-cause, circulatory, and respiratory mortality decreased by 0.98% (95% CI: 0.54-1.42), 1.39% (95% CI: 0.82-1.97), and 0.13% (95% CI: - 1.24 to 1.48), respectively.@*CONCLUSION@#Seasonality of mortality is driven partly by temperature, and its amplitude may be decreasing under a warming climate.


Subject(s)
Cardiovascular Diseases/mortality , Cause of Death , Climate Change/mortality , Cold Temperature/adverse effects , Hot Temperature/adverse effects , Humans , Japan/epidemiology , Mortality/trends , Regression Analysis , Respiratory Tract Diseases/mortality , Seasons , Time
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