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1.
Article in English | WPRIM | ID: wpr-878376

ABSTRACT

Climate change has been referred to as one of the greatest threats to human health, with reports citing likely increases in extreme meteorological events. In this study, we estimated the relationships between temperature and outpatients at a major hospital in Qingdao, China, during 2015-2017, and assessed the morbidity burden. The results showed that both low and high temperatures were associated with an increased risk of outpatient visits. High temperatures were responsible for more morbidity than low temperatures, with an attributed fraction (AF) of 16.86%. Most temperature-related burdens were attributed to moderate cold and hot temperatures, with AFs of 5.99% and 14.44%, respectively, with the young (0-17) and male showing greater susceptibility. The results suggest that governments should implement intervention measures to reduce the adverse effects of non-optimal temperatures on public health-especially in vulnerable groups.


Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Ambulatory Care/statistics & numerical data , Cardiovascular Diseases/therapy , Child , Child, Preschool , China/epidemiology , Cold Temperature/adverse effects , Cost of Illness , Digestive System Diseases/therapy , Facilities and Services Utilization/statistics & numerical data , Female , Hot Temperature/adverse effects , Humans , Infant , Infant, Newborn , Male , Middle Aged , Poisson Distribution , Respiratory Tract Diseases/therapy , Risk Factors , Young Adult
2.
Neumol. pediátr. (En línea) ; 16(3): 110-113, 2021. ilus, tab
Article in Spanish | LILACS | ID: biblio-1344094

ABSTRACT

La escoliosis es una enfermedad frecuente, de evolución variable según su etiología y edad de presentación. El diagnóstico y tratamiento oportuno permiten evitar el compromiso respiratorio, que es su principal complicación. La mayoría de los casos corresponden a escoliosis leves e idiopáticas, pero los casos severos, no idiopáticos o aquellos que presentan síntomas respiratorios, requieren de una evaluación oportuna por el equipo de enfermedades respiratorias. El objetivo de este trabajo es describir las alteraciones de la función pulmonar que se encuentran en niños con escoliosis y dar una orientación acerca de la evaluación y derivación de estos pacientes al neumólogo infantil. Con una evaluación oportuna se pueden iniciar planes de rehabilitación u otras intervenciones que permitan disminuir la morbimortalidad asociada a esta patología.


Scoliosis is a common disease with a variable evolution depending on its etiology and age of presentation. Timely diagnosis and treatment make it possible to avoid respiratory compromise, which is its main complication. Most cases correspond to mild and idiopathic scoliosis, but severe, non-idiopathic cases or those with respiratory symptoms require timely evaluation by the respiratory team. The objective of this work is to describe the pulmonary function alterations found in children with scoliosis and to provide guidance on the evaluation and referral of these patients to the pediatric pulmonologist. With a timely evaluation, rehabilitation plans or other interventions can be initiated to reduce the morbidity and mortality associated with this pathology.


Subject(s)
Humans , Child , Respiratory Function Tests , Respiratory Tract Diseases/etiology , Respiratory Tract Diseases/physiopathology , Scoliosis/complications , Respiratory Tract Diseases/therapy , Spirometry
3.
Rev. chil. pediatr ; 91(4): 597-604, ago. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1138677

ABSTRACT

Resumen: Cada vez es más frecuente la atención médica en la Unidad de Cuidados Intensivos (UCI) de niños o adolescentes inmigrantes como también de aquellos nacidos en nuestro país con padres en tal condición. Esto ha ocasionado, en la actualidad, que el equipo de salud se deba enfrentar con problemas diagnósticos derivados del escaso conocimiento de condiciones genéticas propias de esta población y/o el desarrollo de diversas patologías infrecuentes en nuestro país, algunas resultantes de su condi ción sanitaria. En esta revisión se abordan diversos aspectos de la patología hematológica, infecciosa, parasitaria, respiratoria y cardiovascular, todos tópicos relevantes de conocer durante su estadía en la UCI. Es un deber del equipo de salud actualizarse sobre patologías de baja prevalencia en nuestro país, algunas de ellas muy poco conocidas hasta hace una década, pero que, actualmente, están cada vez más presentes en las UCI del sistema de salud público chileno.


Abstract: It is increasingly common to provide medical care in the Intensive Care Unit (ICU) for immigrant children and adolescents as well as those born in Chile with parents in such condition. Currently, this has caused that the health team has to face diverse infrequent pathologies in our country and/ or diagnostic problems derive from the poor knowledge of genetic conditions of this population, some resulting from their health conditions. This review addresses several aspects of hematological, infectious, parasitic, respiratory, and cardiovascular pathologies, all relevant topics to know during their stay in the ICU. It is a duty of the health team to be updated on pathologies of low prevalence in our country, some of them very little known until a decade ago, but which are currently increasingly present in the ICUs of the Chilean public health system.


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Respiratory Tract Diseases/diagnosis , Respiratory Tract Diseases/ethnology , Respiratory Tract Diseases/therapy , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/ethnology , Cardiovascular Diseases/therapy , Critical Care/methods , Emigrants and Immigrants , Hematologic Diseases/diagnosis , Hematologic Diseases/ethnology , Hematologic Diseases/therapy , Infections/diagnosis , Infections/ethnology , Infections/therapy , Intensive Care Units , Chile/epidemiology , Prevalence
4.
Rev. Paul. Pediatr. (Ed. Port., Online) ; 37(2): 166-172, Apr.-June 2019. tab, graf
Article in English | LILACS | ID: biblio-1013285

ABSTRACT

ABSTRACT Objective: Identify the association between exposure to fine particulate matter and hospitalizations due to respiratory diseases in children up to ten years of age in the city of Cuiabá, Mato Grosso, stratifying the analysis by sex and calculating excess costs. Methods: Ecological study of time series. The dependent variable was daily hospitalizations according to the 10th Revision of the International Classification of Diseases (ICD10): J04.0, J12.0 to J18.9, J20.0 to J21.9 and J45.0 to J45.0. The independent variables were the concentration of fine particulate, estimated by a mathematical model, temperature and relative air humidity, controlled by short and long-term trends. Generalized additive model of Poisson regression was used. Relative risks, proportional attributable risk (PAR) and excess hospitalizations and their respective costs by the population attributable fraction (PAF) were calculated. Results: 1,165 children were hospitalized, 640 males and 525 females. The mean concentration, estimated by the mathematical model, was 15.1±2.9 mcg/m3 for PM2.5. For boys, there was no significant association; for girls a relative risk of up to 1.04 of daily hospitalizations due to respiratory diseases was observed for exposure to PM 2.5 in lags 1, 2 and 6. Increase of 5 µg/m3 in these concentrations increased the percentage of the risk in 18%; with an excess 95 hospital admissions and with excess expenses in the order of US$ 35 thousand. Conclusions: Significant effect in daily hospitalizations due to respiratory diseases related to exposure to fine particulate matter was noted for girls, suggesting the need for stratification by sex in further studies.


RESUMO Objetivo: Identificar associação entre exposição ao material particulado fino e internações por doenças respiratórias em crianças de até dez anos de idade, no município de Cuiabá, MT, estratificando a análise por sexo e calculando excesso de custos. Métodos: Estudo ecológico de séries temporais, sendo a variável dependente o número diário de internações por doenças respiratórias, segundo a 10a Revisão da Classificação Internacional de Doenças (CID): J04.0, J12.0 a J18.9, J20.0 a J21.9 e J45.0 a J45.0. As variáveis independentes foram a concentração do particulado fino, estimada pelo modelo matemático, além de temperatura e umidade relativa do ar, controladas pelas tendências de curta e longa duração. Foram calculados riscos relativos, risco atribuível proporcional (RAP) e excessos de internações e seus respectivos custos pela fração atribuível populacional (FAP). Resultados: Foram internadas 1.165 crianças (640 meninos e 525 meninas). A concentração média estimada do particulado fino foi 15,1±2,9 mcg/m3 para particulado fino (PM2,5). Para meninos, não houve associação significativa. Para meninas, observou-se risco relativo (RR) de até 1,04 para o número diário de internações por doenças respiratórias em associação à exposição ao PM2,5 nos lags 1, 2 e 6. O aumento de 5 mcg/m3 nessas concentrações associou-se ao aumento do risco em 18% e o RAP atribuído à exposição foi de 20% das internações das meninas, com excesso de 95 internações e de gastos da ordem de R$ 105 mil. Conclusões: Houve associação da exposição ao particulado fino e número de internações por doenças respiratórias de meninas, sugerindo a necessidade de estratificação por sexos em estudos posteriores.


Subject(s)
Humans , Male , Female , Child , Sex Factors , Hospitalization/statistics & numerical data , Respiratory Tract Diseases/ethnology , Respiratory Tract Diseases/therapy , Respiratory Tract Diseases/epidemiology , Brazil/epidemiology , Child Health/statistics & numerical data , Risk Factors , Risk Assessment , Inhalation Exposure/adverse effects , Inhalation Exposure/prevention & control , Inhalation Exposure/statistics & numerical data , Air Pollutants/analysis , Air Pollutants/adverse effects , Particulate Matter/analysis , Particulate Matter/adverse effects , Ecological and Environmental Phenomena , Hospitalization/economics
5.
J. bras. pneumol ; 45(3): e20180314, 2019. tab
Article in English | LILACS | ID: biblio-1012558

ABSTRACT

ABSTRACT Smoking is the leading cause of respiratory disease (RD). The harmful effects of smoking on the respiratory system begin in utero and influence immune responses throughout childhood and adult life. In comparison with "healthy" smokers, smokers with RD have peculiarities that can impede smoking cessation, such as a higher level of nicotine dependence; nicotine withdrawal; higher levels of exhaled carbon monoxide; low motivation and low self-efficacy; greater concern about weight gain; and a high prevalence of anxiety and depression. In addition, they require more intensive, prolonged treatment. It is always necessary to educate such individuals about the fact that quitting smoking is the only measure that will reduce the progression of RD and improve their quality of life, regardless of the duration and severity of the disease. Physicians should always offer smoking cessation treatment. Outpatient or inpatient smoking cessation treatment should be multidisciplinary, based on behavioral interventions and pharmacotherapy. It will thus be more effective and cost-effective, doubling the chances of success.


RESUMO O tabagismo é o maior responsável pelas doenças respiratórias (DR). Os efeitos nocivos do tabaco sobre o aparelho respiratório se iniciam ainda intraútero e influenciam as respostas imunológicas ao longo da infância e vida adulta. Os tabagistas com DR possuem peculiaridades que podem dificultar a cessação tabágica, tais como maior grau de dependência e de abstinência de nicotina; níveis mais elevados de monóxido de carbono exalado; motivação e autoeficácia baixas; maior preocupação com ganho ponderal; e elevada prevalência de ansiedade e depressão. Além disso, requerem tratamento mais intensivo e prolongado. É necessário esclarecer sempre o paciente sobre o fato de que parar de fumar será a única medida que irá reduzir a progressão das DR e melhorar sua qualidade de vida, independentemente do tempo e da gravidade da doença. Os médicos devem sempre oferecer o tratamento de cessação tabágica. O tratamento ambulatorial ou hospitalar deve ser multidisciplinar, baseado em intervenções comportamentais e farmacoterapia, sendo eficaz e custo-efetivo, dobrando as chances de sucesso.


Subject(s)
Humans , Respiratory Tract Diseases/etiology , Respiratory Tract Diseases/therapy , Tobacco Use Disorder/complications , Smoking/adverse effects , Smoking Cessation , Tobacco Use Disorder/therapy , Tuberculosis, Pulmonary/etiology , Tuberculosis, Pulmonary/therapy , Risk Factors , Pulmonary Disease, Chronic Obstructive/etiology , Pulmonary Disease, Chronic Obstructive/therapy , Lung Neoplasms/etiology , Lung Neoplasms/therapy
6.
J. bras. pneumol ; 44(1): 42-48, Jan.-Feb. 2018. tab, graf
Article in English | LILACS | ID: biblio-893889

ABSTRACT

ABSTRACT Objective: To evaluate the effectiveness of a smoking cessation program, delivered by trained health care professionals, in patients hospitalized for acute respiratory disease (RD) or heart disease (HD). Methods: Of a total of 393 patients evaluated, we included 227 (146 and 81 active smokers hospitalized for HD and RD, respectively). All participants received smoking cessation treatment during hospitalization and were followed in a cognitive-behavioral smoking cessation program for six months after hospital discharge. Results: There were significant differences between the HD group and the RD group regarding participation in the cognitive-behavioral program after hospital discharge (13.0% vs. 35.8%; p = 0.003); smoking cessation at the end of follow-up (29% vs. 31%; p < 0.001); and the use of nicotine replacement therapy (3.4% vs. 33.3%; p < 0.001). No differences were found between the HD group and the RD group regarding the use of bupropion (11.0% vs. 12.3%; p = 0.92). Varenicline was used by only 0.7% of the patients in the HD group. Conclusions: In our sample, smoking cessation rates at six months after hospital discharge were higher among the patients with RD than among those with HD, as were treatment adherence rates. The implementation of smoking cessation programs for hospitalized patients with different diseases, delivered by the health care teams that treat these patients, is necessary for greater effectiveness in smoking cessation.


RESUMO Objetivo: Avaliar a eficácia de um programa de cessação de tabagismo, oferecido por profissionais da saúde treinados, para pacientes hospitalizados por doença cardíaca (DC) ou doença respiratória (DR). Métodos: Foram avaliados 393 pacientes, sendo incluídos 227 (146 e 81 pacientes tabagistas ativos hospitalizados com DC e DR, respectivamente) que receberam intervenção para cessação tabágica durante a internação com seguimento de seis meses após a alta hospitalar. Resultados: Houve diferenças significativas entre os grupos DC e DR em relação à participação na intervenção cognitivo-comportamental após a alta hospitalar (13,0% vs. 35,8%; p = 0,003); cessação do tabagismo ao final do seguimento (29% vs. 31%; p < 0,001); e uso de terapia de reposição de nicotina (3,4% vs. 33,3%; p < 0,001). Em relação ao uso da bupropiona, não houve diferença entre os grupos DC e DR (11,0% vs. 12,3%; p = 0,92). A vareniclina foi usada em apenas 0,7% dos pacientes do grupo DC. Conclusões: Nesta amostra, os pacientes com DR apresentaram maior taxa de cessação tabágica após seis meses da alta hospitalar e maior adesão ao tratamento. A incorporação de programas de cessação do tabagismo para pacientes hospitalizados com patologias diversas, promovidos pelas equipes que os atendem, é necessária para que ocorra uma maior efetividade na cessação tabágica.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Respiratory Tract Diseases/therapy , Program Evaluation , Smoking Cessation/methods , Heart Diseases/therapy , Hospitalization , Patient Discharge , Time Factors , Reproducibility of Results , Follow-Up Studies , Treatment Outcome , Statistics, Nonparametric , Treatment Adherence and Compliance
7.
Acta pediátr. hondu ; 8(2): 796-809, oct. 2017-mar. 2018. tab
Article in Spanish | LILACS | ID: biblio-1015027

ABSTRACT

El asma es una enfermedad respiratoria crónica y heterogénea que afecta a más de 250 millones de personas en todo el mundo. Su origen es multifactorial y está determina-da por factores predisponentes y desencade-nantes que resultan en un fenotipo específi-co. La forma de presentación más común en niños es el alérgico, de inicio temprano y desencadenada por alérgenos. La sospecha inicial es clínica, con la triada clásica de tos, sibilancias y dificultad respiratoria desenca-denada por factores ambientales específi-cos, empeora con cuadros infecciosos y varía con el tiempo. En mayores de 6 años, la confirmación diagnóstica se hace con pruebas de función respiratoria. En menores de esta edad el diagnóstico es complejo debido a las sibilancias asociadas a infeccio-nes y broncoespasmo post-infeccioso, por lo que se han desarrollado herramientas para ayudar a diferenciarlo. El tratamiento se determinará según la clasificación por severi-dad. La base es el esteroide inhalado, y el objetivo es encontrar la dosis mínima nece-saria para controlar los síntomas siguiendo el esquema escalonado de tratamiento, en el que se puede combinar con otros medica-mentos, según el control que se tenga. Es esencial llevar un seguimiento estrecho, con citas cada tres meses para subir o bajar en la escalera según sea necesario. El uso correc-to de inhaladores es primordial para lograr buen control. En caso de perderse éste puede sobrevenir una crisis. El conocimiento del paciente y sus padres sobre cómo identi-ficarla y tratarla en su inicio, son esenciales Asthma in childrenAsma en el paciente pediátricopara evitar complicaciones...


Subject(s)
Humans , Child , Respiratory Tract Diseases/therapy , Asthma/diagnosis , Nebulizers and Vaporizers , Airway Obstruction/complications
8.
Arq. neuropsiquiatr ; 74(7): 574-579, graf
Article in English | LILACS | ID: lil-787362

ABSTRACT

ABSTRACT Post-polio syndrome (PPS) is a condition that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. Most often, polio survivors experience a gradual new weakening in muscles that were previously affected by the polio infection. The actual incidence of cardiovascular diseases (CVDs) in individuals suffering from PPS is not known. However, there is a reason to suspect that individuals with PPS might be at increased risk. Method A search for papers was made in the databases Bireme, Scielo and Pubmed with the following keywords: post polio syndrome, cardiorespiratory and rehabilitation in English, French and Spanish languages. Although we targeted only seek current studies on the topic in question, only the relevant (double-blind, randomized-controlled and consensus articles) were considered. Results and Discussion Certain features of PPS such as generalized fatigue, generalized and specific muscle weakness, joint and/or muscle pain may result in physical inactivity deconditioning obesity and dyslipidemia. Respiratory difficulties are common and may result in hypoxemia. Conclusion Only when evaluated and treated promptly, somE patients can obtain the full benefits of the use of respiratory muscles aids as far as quality of life is concerned.


RESUMO Síndrome pós-polio (SPP) é uma condição que afeta sobreviventes da poliomielite aguda (PAA), anos após a recuperação de um ataque agudo inicial do vírus. Na maioria das vezes, os sobreviventes da polio começam a apresentar nova paresia gradual nos músculos que foram previamente afetados pela infecção. A incidência real de doenças cardiovasculares (DCV) em indivíduos que sofrem de SPP não é conhecida. Entretanto, há indícios para suspeitar de que sujeitos com SPP podem estar em maior risco. Método Realizou-se uma busca de artigos nas bases de dados: Bireme, Scielo e Pubmed, utilizando as seguintes palavras-chave: síndrome pós-poliomielite, função cardiorrespiratória e reabilitação, nos idiomas Inglês, Francês e Espanhol. Embora tenhamos selecionado um número expressivo de artigos, somente foram considerados os duplo-cegos, randomizados-controlados, além de consensos. Resultados e Discussão Certas características da SPP, tais como fadiga muscular, paresia, dor muscular e/ou articulares podem resultar em descondicionamento por inatividade física, além de obesidade e dislipidemia. Dificuldades respiratórias são comuns e podem resultar em hipoxemia. Conclusão Somente quando avaliados e tratados em tempo hábil, alguns pacientes são capazes de obter os benefícios do uso dos músculos respiratórios auxiliares em termos de qualidade de vida.


Subject(s)
Humans , Respiratory Tract Diseases/etiology , Respiratory Tract Diseases/therapy , Cardiovascular Diseases/etiology , Cardiovascular Diseases/therapy , Postpoliomyelitis Syndrome/complications , Postpoliomyelitis Syndrome/rehabilitation , Respiratory Tract Diseases/physiopathology , Sleep Wake Disorders/etiology , Sleep Wake Disorders/physiopathology , Cardiovascular Diseases/physiopathology , Risk Factors , Postpoliomyelitis Syndrome/physiopathology , Muscle Weakness/physiopathology , Exercise Test
10.
Rev. bras. ter. intensiva ; 27(3): 235-239, jul.-set. 2015. tab
Article in Portuguese | LILACS | ID: lil-761672

ABSTRACT

RESUMOObjetivo:Avaliar relação entre a mortalidade intra-hospitalar de pacientes internados por doenças respiratórias e a disponibilidade de unidades de terapia intensiva.Métodos:Foi realizada coorte retrospectiva do banco de dados em um serviço de medicina hospitalar. Selecionaram- se pacientes internados por doenças respiratórias não terminais. Características clínicas, fatores de risco associado à mortalidade, como o escore de Charlson, e tempo de internação foram coletados. Foram realizados: análise univariada com estratificação simples por Mantel Haenszel, e testes qui quadrado, t de Student e Mann-Whitney, além de regressão logística.Resultados:Foram selecionados 313 pacientes, 98 (31,3%) antes da instalação da unidade de terapia intensiva e 215 (68,7%) após a disponibilização de unidade de terapia intensiva. Quando comparados quanto a características clínicas, antropométricas e fatores de risco, não houve diferença significativa. A mortalidade antes da disponibilidade da unidade de terapia intensiva foi de 18/95 (18,9%) e, após, de 21/206 (10,2%). Na regressão logística, a chance de morte após implantação da unidade de terapia intensiva diminuiu em 58% (OR: 0,42; IC95% 0,205 - 0,879; p = 0,021).Conclusão:Respeitando as limitações do estudo, conjetura-se benefício na redução de uma morte a cada 11 pacientes tratados por doenças respiratórias após a implantação da unidade de terapia intensiva no hospital. Estes resultados corroboram a impressão do benefício da implantação de unidades de terapia intensiva em hospitais de nível secundário.


ABSTRACTObjective:To evaluate the association between the in-hospital mortality of patients hospitalized due to respiratory diseases and the availability of intensive care units.Methods:This retrospective cohort study evaluated a database from a hospital medicine service involving patients hospitalized due to respiratory non-terminal diseases. Data on clinical characteristics and risk factors associated with mortality, such as Charlson score and length of hospital stay, were collected. The following analyses were performed: univariate analysis with simple stratification using the Mantel Haenszel test, chi squared test, Student’s t test, Mann-Whitney test, and logistic regression.Results:Three hundred thirteen patients were selected, including 98 (31.3%) before installation of the intensive care unit and 215 (68.7%) after installation of the intensive care unit. No significant differences in the clinical and anthropometric characteristics or risk factors were observed between the groups. The mortality rate was 18/95 (18.9%) before the installation of the intensive care unit and 21/206 (10.2%) after the installation of the intensive care unit. Logistic regression analysis indicated that the probability of death after the installation of the intensive care unit decreased by 58% (OR: 0.42; 95%CI 0.205 -0.879; p = 0.021).Conclusion:Considering the limitations of the study, the results suggest a benefit, with a decrease of one death per every 11 patients treated for respiratory diseases after the installation of an intensive care unit in our hospital. The results corroborate the benefits of the implementation of intensive care units in secondary hospitals.


Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Hospitalization/statistics & numerical data , Intensive Care Units , Respiratory Tract Diseases/therapy , Brazil , Cohort Studies , Length of Stay , Logistic Models , Retrospective Studies , Risk Factors , Respiratory Tract Diseases/mortality
11.
Rev. chil. cir ; 67(4): 448-455, ago. 2015. tab
Article in Spanish | LILACS | ID: lil-752867

ABSTRACT

Chronic respiratory disease is the 3rd leading cause of death in Chile and its prevalence is increasing significantly in the world, so it is very common that we find patients with these pathologies undergoing elective surgical procedures. Perioperative complications are more frequent in these patients than in the general population, so it is essential adequate preoperative evaluation and management in them. Chronic obstructive pulmonary disease (COPD) is a major predictor of postoperative complications; therefore preoperative bronchodilators and inhaled corticosteroids are indicated in patients with this disease who will undergo elective surgery, particularly related to lung cancer. Likewise, COPD patients who will undergo coronary artery bypass graft surgery (CABG) should receive oral or intramuscular corticosteroids preoperatively. Smoking is an independent risk factor for developing postoperative respiratory complications in thoracic surgery, so patients should stop this habit at least 4 weeks before elective surgery in order to significantly reduce such complications. A poorly controlled asthma is a specific risk factor for developing postoperative pulmonary complications, therefore these patients should be treated preoperatively with inhaled bronchodilators exclusive if they have mild asthma, bronchodilators associated with inhaled corticosteroids in the case of a moderate asthma, and inhaled bronchodilators associated to inhaled and oral corticosteroids, if they have severe asthma.


Las enfermedades respiratorias crónicas son la tercera causa de muerte en Chile y su prevalencia está aumentando significativamente en el mundo, por lo cual es muy frecuente que nos encontremos con pacientes con estas patologías sometiéndose a procedimientos quirúrgicos electivos. En estos casos las complicaciones perioperatorias son más frecuentes que en la población general, por lo cual es indispensable una adecuada evaluación y manejo preoperatorio. La presencia de enfermedad pulmonar obstructiva crónica (EPOC) es un predictor mayor de complicaciones postoperatorias y deben indicarse broncodilatadores y corticoides inhalatorios preoperatorios en pacientes con esta patología que serán sometidos a cirugía electiva, especialmente en la relacionada a cáncer pulmonar. Así mismo, los pacientes con EPOC que se someterán a cirugía de revascularización miocárdica deben recibir además corticoides vía sistémica en el período preoperatorio. El tabaquismo es otro factor de riesgo independiente para desarrollar complicaciones respiratorias postoperatorias en cirugía torácica, por lo que los pacientes deberían suspender el consumo de tabaco por lo menos 4 semanas antes de la cirugía programada con el fin de disminuir significativamente dichas complicaciones. El asma bronquial mal controlada también es un factor de riesgo específico para desarrollar complicaciones pulmonares postoperatorias, por lo cual estos pacientes deben tratarse preoperatoriamente con broncodilatadores inhalatorios, asociados a corticoides inhalatorios u orales según la gravedad del asma.


Subject(s)
Humans , Respiratory Tract Diseases/therapy , Preoperative Care , Asthma/therapy , Chronic Disease , Pulmonary Disease, Chronic Obstructive/therapy , Smoking/therapy
12.
Homeopatia Méx ; 84(695): 13-18, mar.-abr. 2015.
Article in Spanish | LILACS | ID: lil-762167

ABSTRACT

El presente trabajo tiene el objetivo de mostrar el efecto terapéutico de algunos medicamentos homeopáticos en la rinofaringitis aguda o resfriado común, enfermedad aguda de vías respiratorias superiores de tipo viral de baja patogenicidad (VRSBP) y gran incidencia en la actualidad, en una muestra piloto de tipo clínico, longitudinal y prospectiva, conformada por 22 pacientes captados en la Unidad Médica de la Escuela Nacional de Medicina y Homeopatía (ENMH) del Instituto Politécnico Nacional (IPN); 15 pacientes del sexo femenino y 7 del masculino, en un rango de entre 4 y 11 años de edad. La elección de los medicament s homeopáticos se realizó con base en lasemiología de los síntomas presentados, enfatizando particularmente en las modalidades, el color del moco, ataque al estado general y la exploración física.


This paper aims to show the therapeutic effect of some homeopathic medicines in acute nasopharyngitis or common cold , acute upper respiratory disease of viral type low pathogenic ( VRSBP ) and high incidence currently in a pilot sample clinical , longitudinal and prospective type , consisting of 22 patients recruited in the Medical Unit of the National School of Medicine and Homeopathy ( ENMH ) of the National Polytechnic Institute ( IPN) ; 15 female patients and 7 male , ranging between 4 and 11 years old. The choice of homeopathic medicament s was made based on thesemiotics of the symptoms presented , emphasizing particularly on the modalities , the color of mucus, malaise and physical examination.


Subject(s)
Humans , Male , Female , Child , Onions/therapeutic use , Bryonia/therapeutic use , Homeopathic Therapeutics , Nasopharyngitis/therapy , Respiratory Tract Diseases/therapy , Homeopathic Remedy , Virus Diseases
13.
Rev. Méd. Clín. Condes ; 26(3): 357-366, mayo 2015. ilus, tab
Article in Spanish | LILACS | ID: biblio-1129131

ABSTRACT

Las enfermedades ocupacionales son aquellas producidas directamente por el ejercicio de la profesión. Estas se encuentran reguladas por la Ley 16.744 y son de cargo de prestadores de servicios denominados habitualmente mutuales. En este artículo se describen los principales aspectos epidemiológicos, fisiopatológicos, clínicos, de criterios diagnósticos y principios terapéuticos, de cuatro enfermedades respiratorias, las más relevantes en el medio nacional: Silicosis, asma, enfermedades por asbesto y enfermedades por hipobaria.


Occupational diseases are those produced directly by work activities. In Chile, occupational diseases are regulated by the law 16.744 and the service providers are called, mutualidades. In this paper is described epidemiology, physiopathology, clinical aspects, diagnostic criteria and therapeutic principles of the four most important occupational respiratory diseases in Chile: Silicosis, occupational asthma, asbestos diseases and altitude sickness.


Subject(s)
Humans , Respiratory Tract Diseases/diagnosis , Respiratory Tract Diseases/etiology , Respiratory Tract Diseases/therapy , Occupational Diseases/diagnosis , Occupational Diseases/etiology , Occupational Diseases/therapy , Asbestosis , Respiratory Tract Diseases/physiopathology , Silicosis , Altitude Sickness , Asthma, Occupational , Hypoxia , Occupational Diseases/physiopathology
15.
Rev. pediatr. electrón ; 10(2)ago. 2013. tab, graf
Article in Spanish | LILACS | ID: lil-718967

ABSTRACT

Objetivo: Evaluar el impacto de la indicación ministerial de la vacunación contra Influenza a lactantes sanos entre 6 y 24 meses iniciada en el año 2006. Material y método: Revisión retrospectiva de fichas clínicas de pacientes hospitalizados por infección respiratoria causada por virus Influenza entre enero 2004 y diciembre 2007 en el Hospital Roberto del Río. Todos los casos fueron confirmados mediante inmunofluorescencia viral positiva para Influenza A o B. Resultados: De un total de 224 pacientes, 122 corresponden al período prevacuna (años 2004-2005) y 102 al postvacuna (años 2006-2007). La tasa de hospitalización fue similar para todos los años estudiados. Durante el período postvacuna recibieron vacunación solo 4 de los 102 pacientes, el 68 por ciento de los no vacunados se encontraban al momento de la campaña ministerial fuera del rango etario con indicación de vacunación. El 70 por ciento de los hospitalizados corresponden a pacientes menores de 2 años en ambos grupos. No se registró diferencia estadísticamente significativa en sexo, días de hospitalización, requerimientos de oxígeno, ingreso a UCI ni necesidad de ventilación mecánica invasiva. Un 75 por ciento de los hospitalizados corresponde a pacientes sin comorbilidad. Se evidencia un cambio en el patrón estacional de las infecciones por Influenza luego de la introducción de la vacuna manteniéndose éstas presentes a lo largo de todo el año. Conclusiones: No existe una disminución en la tasa de hospitalización ni cambios en las características clínicas de los pacientes hospitalizados luego de la introducción de la vacuna. Si se evidencia un cambio en la distribución estacional con un aplanamiento de la curva a diferencia de la clásica presentación en brote descrita en la literatura y observada en nuestro país previo a esta medida.


Objective: To evaluate the impact of the ministerial statement of vaccination against influenza in healthy infants in the age group of 6 and 24 months since 2006. Material and Methods: Retrospective review of medical records of patients hospitalized due to respiratory infection caused by influenza virus between January 2004 and December 2007 at the Hospital Roberto del Río. All cases were confirmed by positive immunofluorescence for influenza virus A or B. Results: Of a total of 224 patients, 122 are from the pre-vaccination period (2004-2005) and 102 from post vaccination period (2006-2007). The hospitalization rate was similar during the study time course. During the post vaccination period only 4 of 102 patients received vaccination, meanwhile 68 percent of them were out of age requirements for the vaccination ministerial campaign. 70 percent of hospitalized patients are younger than 2 years in both groups. There were not significant differences in sex, hospital stay, oxygen requirements, ICU admission or in the need of invasive mechanical ventilation. 75 percent of hospitalized patients did not exhibit comorbility. These results show a change in the seasonal pattern of influenza infections after the vaccine introduction that remains all over the years. Conclusions: There is not a decrease in the hospitalization rate or a change in the clinical characteristics of hospitalized patients after the vaccine introduction. There is a clear change in the seasonal distribution with a curve flattening, unlike the classic outbreak presentation described in literature and observed in our country prior to this program.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Influenza, Human/epidemiology , Influenza, Human/prevention & control , Hospitalization/statistics & numerical data , Influenza Vaccines/administration & dosage , Age and Sex Distribution , Chile , Evaluation of Results of Preventive Actions , Respiratory Tract Diseases/epidemiology , Respiratory Tract Diseases/therapy , Length of Stay , Retrospective Studies , Seasons , Severity of Illness Index , Intensive Care Units/statistics & numerical data
18.
Rev. latinoam. enferm ; 20(3): 453-461, May-June 2012. ilus
Article in English | LILACS, BDENF | ID: lil-649685

ABSTRACT

This study's purpose was to identify the therapeutic journey of families seeking health care for their children with respiratory diseases. This qualitative study had the participation of parents of children younger than five years old who were hospitalized with respiratory diseases. Path mapping was used as an instrument to collect data, which was analyzed through thematic analysis. The findings indicate that families sought the health services as soon as they perceived symptoms and had access to medical care, however such care was not decisive in resolving their health issues. Even though the families returned to the service at least another three times, the children had to be hospitalized. The attributes of primary health care were not observed in the public health services, while therapeutic encounters had no practical success.


O objetivo deste estudo foi identificar o itinerário terapêutico de famílias em busca de cuidado para sua criança com doença respiratória. Trata-se de pesquisa sob abordagem qualitativa, com participação de familiares de crianças menores de cinco anos, hospitalizadas com doenças respiratórias. Utilizou-se como instrumento de produção de dados a dinâmica mapa falante, com análise temática dos dados. Os achados indicam que as famílias buscam um serviço de saúde assim que percebem os sintomas e que tiveram acesso a atendimento médico, embora com pouca resolutividade. Observou-se que retornaram ao serviço por pelo menos três vezes e que, mesmo assim, culminou com a hospitalização. Os atributos da atenção básica não foram contemplados nos serviços públicos de saúde, nem o encontro terapêutico obteve sucesso prático.


El estudio tuvo como objetivo identificar el itinerario terapéutico de las familias que buscan cuidar de su hijo con la enfermedad respiratoria. Esta es una investigación con un enfoque cualitativo, con la participación de las familias con niños menores de cinco años de edad, hospitalizados con enfermedades respiratorias. Fue utilizado como un instrumento de producción de los datos el mapa hablado, con una analice temática de los datos. Los resultados indican que las familias buscan un servicio de salud así que perciben los síntomas y que tenían acceso a la atención médica, pero con poca resolución. Se observó que volverán al servicio durante al menos tres veces, y aun así terminó con la hospitalización. Los atributos de la atención primaria no fueron observados en los servicios de salud pública, ni el encuentro tuvo un éxito práctico.


Subject(s)
Adult , Child, Preschool , Female , Humans , Young Adult , Child Health Services , Family , Patient Acceptance of Health Care , Respiratory Tract Diseases/therapy , Brazil , Public Health
19.
Rev. méd. Chile ; 140(5): 616-624, mayo 2012. tab
Article in Spanish | LILACS | ID: lil-648588

ABSTRACT

Background: As the focus of healthcare provision shifts towards ambulatory care, increasing attention must now be given to develop opportunities for clinical teaching in this setting. Aim: To assess teacher and students' views about the strengths and weaknesses of real and simulated patient interactions for teaching undergraduate students clinical skills in the ambulatory setting. Material and Methods: Fourth-year medical students were exposed in a systematic way, during two weeks, to real and simulated patients in an outpatient clinic, who presented common respiratory problems, such as asthma, chronic obstructive pulmonary disease, smoking and sleep apnea syndrome. After the clinical interview, students received feedback from the tutor and their peers. The module was assessed interviewing the teachers and evaluating the results qualitatively. Students evaluated the contents and quality of teaching at the end of the rotation. Results: Tutors identified the factors that facilitate ambulatory teaching. These depended on the module design, resources and patient care, of characteristics of students and their participation, leadership and interaction with professors. They also identified factors that hamper teaching activities such as availability of resources, student motivation and academic recognition. Most students evaluated favorably the interaction with real and simulated patients in the ambulatory setting. Conclusions: Teaching in the ambulatory setting was well evaluated by students and teachers. The use of qualitative methodology allowed contrasting the opinions of teachers and students.


Subject(s)
Humans , Ambulatory Care , Education, Medical, Undergraduate , Faculty, Medical/standards , Respiratory Tract Diseases , Teaching/standards , Chile , Curriculum , Qualitative Research , Respiratory Tract Diseases/therapy , Teaching/methods
20.
Bogotá; s.n; 2012. 51 p. tab, graf.
Thesis in Spanish | MTYCI, LILACS, MTYCI | ID: biblio-876977

ABSTRACT

El uso de medicamentos homeopáticos se ha popularizado especialmente por carecer de reacciones adversas y contraindicaciones. Nux vómica es un remedio ampliamente utilizado para tratar múltiples afecciones como alergias, trastornos digestivos, estrés y cáncer entre otros. Los numerosos estudios sobre las acciones farmacológicas de Nux vómica, no arrojan evidencia científica sobre sus efectos específicos en la respuesta inmune. Con el presente trabajo se pretende evaluar los efectos de Nux vómica homeopatizada sobre la expresión de algunas citoquinas. Materiales y Métodos: Mediante ensayo in vitro, las células mononucleares cultivadas fueron expuestas a la acción de Nux vómica diluída a la potencia 30 CH. Se determinó la viabilidad celular y se cuantificaron los niveles de las citoquinas IL 1ß, IL 2, IL 4, IL 6, IL 8 e IL 10 con el kit de inmunoensayo "Human Cytokine Magnetic 10-Plex Panel" de Invitrogen®. Resultados: Respecto a la viabilidad de los linfocitos, el efecto proliferativo no fue mayor al 11%. En cuanto a la expresión de citoquinas, solo en el caso de IL-4 se obtuvo un valor estadísticamente significativo (p< 0,001). Conclusiones: Nux vómica a la 30 CH no es citotóxica y logra estimular la cascada deseñalización intracelular. La expresión de IL 4 permite argumentar que Nux vómica es un medicamento adecuado para tratar enfermedades de tipo inflamatorio y alérgico.


Subject(s)
Humans , Leukocytes, Mononuclear , Strychnos nux-vomica , Cytokines , Respiratory Tract Diseases/therapy , In Vitro Techniques , Lymphoproliferative Disorders
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