Risk factors and determinants of pulmonary function impairments in chronic respiratory diseases in Ethiopia: A hospital-based cross-sectional study

Introduction: Chronic respiratory diseases (CRDs) are diseases of the lung airways and parenchyma. Globally, they are the leading causes of morbidity and mortality. This study aimed to characterize the common CRDs, along with their lung function and possible determinants in symptomatic patients attending Bishoftu General Hospital, Ethiopia. Methods: A cross-sessional study was conducted at the outpatient of Bishoftu Hospital, Ethiopia from June 2019 to March 2020. Consecutive adult patients aged 18 and above with CRDs (≥8 weeks) were recruited. Questionnaires were used to collect data on demographics, symptoms, diagnoses, and putative risk factors. Lung function was measured by spirometry. Result: A total of 170 participants were recruited, the majority 102(60.0%) were female. The mean age was 49 years (SD=16). The most common symptoms were wheezing in the last twelve months 156 (91.8%), cough 138 (81.2%), and severe exertional breathlessness 137 (80.6%). Thirty-nine (22.9%) were either active or passive smokers. Half of the patients (50.3%) were exposed daily to vapors, dust, gases, or fumes and 58 (34.3%) were exposed to biomass smoke. In total, 138 (81.2%) had a positive allergen skin prick test. Chronic bronchitis (49.1%) and asthma (36.1%) were the most common clinical diagnoses. Classification of lung function revealed 23 (15%) normal, 29 (19%) obstructive, 36(23.5%) restrictive and 61(39.9%) mixed patterns. Airflow obstruction was independently associated with increasing age (p<0.05), exertional breathlessness (p<0.001), previous history of asthma (p<0.05), BMI (p<0.05), and doctor-diagnosed chronic obstructive pulmonary disease (p<0.001) and asthma (p<0.05). Conclusion: This study shows a high burden of abnormal lung function in patients attending clinics because of CRDs symptoms. These findings support the critical need for spirometry services to determine lung abnormality in patients with chronic respiratory symptoms.

Relación de las Enfermedades Crónicas no Transmisibles y Ejercicio Físico en la Población Chilena entre los años 2015-2016 / Risk of Retention of Secretions in Patients with Invasive Mechanical Ventilation

Introducción. Las prevalencias de la inactividad física, el sedentarismo y el sobrepeso y obesidad han aumentado sus índices durante los últimos años en Chile, lo que conlleva al desarrollo y aparición de diversas enfermedades crónicas no transmisibles, como por ejemplo, hipertensión arterial, diabetes mellitus e inclusive enfermedades respiratorias, las cuales repercuten negativamente en la población y deterioran la calidad de vida de las personas, independientemente el sexo y el rango etario. El ejercicio físico es una de las principales herramientas utilizadas por diversos profesionales de la salud como método de prevención y tratamiento en la población afectada, inclusive representa una alternativa de menor costo. Objetivo. Relacionar el ejercicio físico de alta y mediana intensidad con las enfermedades crónicas no transmisibles en personas mayores a 18 años residentes en Chile durante el periodo 2015-2016. Métodos. Análisis cuantitativo, descriptivo, transversal y retrospectivo de base secundaria ENCAVI 2015-2016, de residentes en Chile mayores de 18 años y con al menos una de las siguientes condiciones de salud: Hipertensión arterial, Diabetes Mellitus y enfermedades respiratorias crónicas no transmisibles. Resultados. Todas las variables presentan relaciones significativas (p<0,005) (HTA, DM, enfermedades respiratorias, edad, horas sentado, ejercicio físico de moderada y alta intensidad. Sin embargo, las variables de ejercicio físico moderada intensidad y enfermedades respiratorias (p=0,578) y las variables de sexo y horas sentado (p=0,005) no presentan relación significativa. Discusión. El ejercicio físico de moderada intensidad es el que tiene mejor respuesta ante las diferentes patologías según diferentes autores, por otro lado, en la recopilación de datos podemos encontrar que este tipo de ejercicio es efectivo en la Diabetes Mellitus. Conclusiones. Según los datos analizados, mientras mayor frecuencia de ejercicio físico de alta intensidad (en días) y ejercicio físico de moderada intensidad (en horas) se realice durante los últimos días de la semana, los diagnósticos de las enfermedades crónicas no transmisibles (HTA, DM) y enfermedades respiratorias se verán controladas, mientras que, cuando existe menor frecuencia del ejercicio físico realizado durante los últimos días de la semana, tiende a existir mayor diagnóstico.

Background. The prevalence of physical inactivity, sedentary lifestyle, and overweight and obesity have increased their rates in recent years in Chile, which leads to the development and appearance of various chronic non-communicable diseases, such as for example, arterial hypertension, diabetes mellitus and even respiratory diseases, which have a negative impact on the population and deteriorate the quality of life of people, regardless of gender and age range (7). Physical exercise is one of the main tools used by various health professionals as a method of prevention and treatment in the affected population, even representing a lower cost alternative. Objetive. To relate high and medium intensity physical exercise with chronic non-communicable diseases in people over 18 years of age residing in Chile during the period 2015-2016. Methods. Quantitative, descriptive, cross-sectional and retrospective analysis of the ENCAVI 2015-2016 secondary base of residents in Chile over 18 years of age and with at least one of the following health conditions: High blood pressure, Diabetes Mellitus and chronic non-communicable respiratory diseases. Results. All the variables present significant relationships (p<0.005) (HTN, DM, respiratory diseases, age, hours sitting, moderate and high intensity physical exercise. However, the variables of moderate intensity physical exercise and respiratory diseases (p=0.578) and the variables of sex and sitting hours (p=0.005) do not present a significant relationship. Discussion. Moderate intensity physical exercise is the one that has the best response to different pathologies according to different authors, on the other hand, in data collection we can found that this type of exercise is effective in Diabetes Mellitus. Conclusions. According to the data analyzed, the greater the frequency of high-intensity physical exercise (in days) and moderate-intensity physical exercise (in hours) performed during the last days of the week, the diagnoses of chronic non-communicable diseases (HTN, DM) and respiratory diseases will be controlled, while, when there is less frequency of physical exercise carried out during the last days of the week, there tends to be a greater diagnosis.

Características clínicas y demográficas de los niños hospitalizados con infección por SARS-CoV-2

Introducción: en marzo de 2020 se registraron los primeros casos de infección por SARS-CoV-2 en Uruguay y se decretó la emergencia sanitaria. Objetivo: describir las características clínicas demográficas de los menores de 15 años hospitalizados con infección por SARS-CoV-2 en el período 13 de marzo de 2020 al 30 de septiembre de 2021 en el Hospital Pediátrico del Centro Hospitalario Pereira Rossell, centro de referencia público de Uruguay. Metodología: estudio descriptivo, retrospectivo, en el que se describen edad, manifestaciones clínicas, comorbilidades, severidad, tratamiento y evolución. Resultados: se hospitalizaron 207 niños con una frecuencia de 1,6%. La mediana (rango intercuartil) de edad fue 1,5 años (3 meses - 8 años); <1 año 44%; 54% de sexo masculino. Presentaron comorbilidades, 59 niños. Fueron sintomáticos, 71%. De los sintomáticos, presentaron síntomas leves 48%. Las manifestaciones clínicas fueron respiratorias en 96 (65%) y no respiratorias en 51 (fiebre sin foco 15, digestivas 19, exantema viral 3, SIM-Ped S 10 y atípicas 3). Treinta niños ingresaron a unidad de cuidados intensivos (UCI) y tres requirieron ventilación invasiva. Estos pacientes presentaron comorbilidades, tuvieron más días de fiebre y necesitaron oxigenoterapia que los que no requirieron UCI. Un paciente de 2 años con comorbilidades falleció. Conclusión: la frecuencia de hospitalizaciones fue de 1,6%. La mayoría de los niños sintomáticos presentaron formas leves. En los sintomáticos las manifestaciones fueron respiratorias. Los hallazgos en esta serie aportan al conocimiento del comportamiento de la infección por SARS-CoV-2 en niños.

Introduction: in March 2020, the first cases of SARS CoV-2 infection were registered in Uruguay and a health emergency was decreed. Objective: To describe the clinical and demographic characteristics of children under 15 years of age hospitalized with SARS-CoV-2 infection from March 13, 2020, to September 30, 2021, at Pereira Rossell Pediatric Hospital, a public reference center in Uruguay. Method: descriptive, retrospective study describing age, clinical manifestations, comorbidities, severity and treatment. Results: a total of 207 children were hospitalized, with a frequency of 1.6%. The median (interquartile range) age was 1.5 years (3 months - 8 years); <1 year accounted for 44%, and 54% were male. Comorbidities were present in 59 children. 71% of them were symptomatic, and among the symptomatic cases, 48% presented mild symptoms. Clinical manifestations were respiratory in 96 (65%) cases and non-respiratory in 51 (fever without a focus 15, gastrointestinal 19, viral exanthem 3, pediatric inflammatory multisystem syndrome 10, and atypical 3). Thirty patients were admitted to the Intensive Care Unit (ICU), and 3 required invasive ventilation. These patients had comorbidities, more days of fever, and required oxygen therapy compared to those who did not need ICU. One 2-year-old patient with comorbidities died. Conclusion: the hospitalization frequency was 1.6%. Most symptomatic children had mild forms of the disease. Among the symptomatic cases, respiratory manifestations were predominant. The findings from this series contribute to the understanding of the behavior of SARS-CoV-2 infection in children.

Introdução: Os primeiros casos de infecção por SARS CoV-2 no Uruguai foram registrados em março de 2020 quando foi decretada a emergência sanitária. Objetivo: descrever as características clínicas e demográficas das crianças menores de 15 anos internadas com infecção por SARS CoV-2 no período 13 de março de 2020 - 30 de setembro de 2021 no Hospital Pediátrico do Centro Hospitalar Pereira Rossell, centro público de referência no Uruguai. Metodologia: estudo descritivo, retrospectivo, incluindo idade, manifestações clínicas, comorbidades, gravidade, tratamento e evolução. Resultados: 207 crianças foram internadas com infecção por SARS CoV-2 correspondendo a frequência de 1,6% do total de crianças hospitalizadas no período estudado. A mediana (intervalo interquartil) de idade foi de 1,5 anos (3 meses - 8 anos) dos quais 44% eram <1 ano 44% e 54% do sexo masculino. 59 crianças apresentaram comorbidades. 71% eram sintomáticas sendo que 48% delas apresentaram sintomas leves. As manifestações clínicas foram respiratórias em 96 (65%) e não respiratórias em 51 (febre sem foco 15, digestiva 19, exantema viral 3, SIM-Ped S 10 e atípico 3). 30 crianças foram internadas na Unidade de Terapia Intensiva e 3 precisaram de ventilação invasiva; esses pacientes apresentavam comorbidades, necessitaram de oxigenoterapia e tiveram mais dias de febre do que aqueles que não necessitaram de UTI. Uma paciente de 2 anos com comorbidades faleceu. Conclusão: a frequência de internações foi de 1,6%. A maioria das crianças sintomáticas apresentou formas leves. Nas sintomáticas as manifestações foram respiratórias. Os achados desta série contribuem para o conhecimento do comportamento da infecção por SARS CoV-2 em crianças.

SARS-CoV-2 induced changes in the lungs based on autopsy cases

Context: Researchers throughout the world devote enormous efforts to reveal the peculiarities of the pathogenesis of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, however, it continues to surprise and cause the death of millions of people. Aims: This article aims to study the molecular mechanisms provoked by SARS-CoV-2, the virus-induced changes in Angiotensin-converting enzyme 2 (ACE2) functionality, in the vascular homeostasis through CD34 expression, B-cell immunity through the expression of CD20 and CD79?, and adhesion molecules through E-cadherin. Settings and Design: This was a prospective, descriptive, and observational study. Methods and Material: A total of 15 autopsies of patients deceased by COVID-19 infection, confirmed by PCR, were performed. The lungs of all patients were examined histologically and immunohistochemically for ACE2, E-cadherin, CD34, CD20, and CD79?. Results: Immunohistological analysis showed increased ACE2 expression in all lung autopsy material affected by COVID-19 infection and we found a higher intensity of ACE2 expression than that of a healthy lung. CD20 examination reveals total deficiency of B-cells in the pulmonary parenchyma and CD79? is also absent. E-Cadherin is not expressed in the basal cellular sections where the contact elements are missing. CD34 demonstrates a desquamation of the endothelial cells, which indicates a direct damage of the vascular walls. Conclusions: We found that patients who died after severe COVID-19 had high immune deficiency and impaired intercellular communication in the parenchyma and endothelium of lung tissue, leading to severe thromboembolic complications in patients with multiple diseases.

Consultas por enfermedades respiratorias agudas en la población pediátrica y su relación con el material particulado atmosférico en Bahía Blanca: un estudio ecológico / Consultations for acute respiratory diseases in the pediatric population and their relationship with atmospheric particulate matter in Bahía Blanca: an ecological study

Introducción. El material particulado (PM) es uno de los contaminantes del aire que mayor implicación tienen en la aparición o exacerbación de cuadros respiratorios en niños. Objetivo. Describir las características de las consultas por enfermedades respiratorias agudas en menores de 15 años, los niveles de PM en el aire, y analizar la asociación existente entre ellos en un sector de Bahía Blanca entre abril de 2019 y marzo de 2020. Población y métodos. Estudio ecológico de series temporales y grupos múltiples. Análisis descriptivo de consultas totales, por área, diagnóstico, y del PM. Modelo de correlación y regresión lineal generalizado para determinar la relación entre las variables. Se utilizó el programa SPSS®. Resultados. Se recopilaron 4787 consultas. Un 38,6 % (1846) correspondieron a rinitis y un 21,1 % (1011) a broncoespasmo. El PM de 10 nm (PM10) superó su valor límite el 31 % (115) de los días de estudio y el de 2,5 nm (PM2,5) un 3 % (8). Un aumento del 10 % del PM2,5 demostró incrementos de 1,3 % en las consultas totales; el incremento llegó al 2,1 % en el área más cercana al sector industrial (p <0,05). En esta última, el aumento del 10 % de los valores de PM10 se asoció al aumento del 1,8 % de las consultas (p <0,05). Conclusión. Se demostró asociación positiva entre las consultas por enfermedad respiratoria aguda y los niveles de PM del aire, sobre todo con el PM2,5 y en el área más cercana al sector industrial.

Introduction. Particulate matter (PM) is one of the air pollutants most involved in the onset or exacerbation of respiratory conditions in children. Objective. To describe the characteristics of consultations for acute respiratory diseases in children younger than 15 years and the levels of PM in the air and to analyze their association in a sector of Bahía Blanca between April 2019 and March 2020. Population and methods. Ecological, time-series study with multiple groups. Descriptive analysis of total number of consultations, by area, diagnosis, and PM. Generalized linear correlation and regression model to determine the relationship among variables. The SPSS® software was used. Results. Data from 4787 consultations were collected. Of these, 38.6% (1846) were related to rhinitis and 21.1% (1011), to bronchospasm. PM of 10 nm (PM10) exceeded its limit value on 31% (115) of the study days, and PM of 2.5 nm (PM2.5), on 3% (8). A 10% increase in PM2.5 showed increases of 1.3% in total consultations; the increase reached 2.1% in the area closest to the industrial sector (p < 0.05). In the latter, a 10% increase in PM10 was associated with an increase of 1.8% in consultations (p < 0.05). Conclusion. A positive association was evidenced between consultations for acute respiratory diseases and PM levels in the air, especially with PM2.5 and in the area closest to the industrial sector.

Correlation between atmospheric nitrogen oxides and nitrogen dioxide acute exposure and outpatient visits of pediatric respiratory diseases / 预防医学

Objective @#To examine the association between acute exposure to traffic-related air pollutants (TRAP) NOX and NO2 and outpatient visits of pediatric respiratory diseases. @*Methods @#Data regarding outpatient visits to Department of Respiratory Diseases of Beijing Children's Hospital from 2015 to 2020 were collected, and the concentrations of nitrogen oxides (NOX), nitrogen dioxide (NO2) and other TRAP were collected from the surveillance sites assigned by the Peking University Health Science Center. A time-stratified case-crossover design was employed, and a conditional logistic regression model was created to examine the association between NOX and NO2 acute exposure and outpatient visits of pediatric respiratory diseases. @*Results @#The daily mean outpatient visits of pediatric respiratory diseases were 571 (interquartile range, 554) person-times among children at ages of 0 to 14 years in Beijing Children's Hospital from 2015 to 2020, and the daily mean outpatient visits for upper respiratory tract infections (URI), bronchitis, and pneumonia were 265 (interquartile range, 282), 143 (interquartile range, 178) and 128 (interquartile range, 120) person-times, respectively. The daily mean concentrations of atmospheric NOX and NO2 were 67.8 (interquartile range, 50.7) and 49.3 (interquartile range, 30.7) μg/m3, respectively. Conditional logistic regression analysis showed the largest lagged effect of NOX and NO2 on pediatric respiratory diseases at cumulative lags of 0 to 7 days. An increase in NOX concentrations by an interquartile range resulted in the excess risks of URI, bronchitis and pneumonia by 6.87% (95%CI: 6.37%-7.38%), 7.25% (95%CI: 6.51%-7.99%), and 5.51% (95%CI: 4.69%-6.33%), and an increase in NO2 concentrations by an interquartile range resulted in excess risks of URI, bronchitis and pneumonia by 5.71% (95%CI: 5.12%-6.31%), 5.32% (95%CI: 4.51%-6.14%), and 4.83% (95%CI: 3.91%-5.75%), respectively. NOX and NO2 presented a more remarkable effect on outpatient visits of pediatric respiratory diseases among children at ages of over 5 years. @*Conclusion @#NOx and NO2 acute exposure may increase the outpatient visits of pediatric respiratory diseases.

Clinical Evidence of Chinese Patent Medicines in Treatment of Respiratory Diseases in Children： A Scoping Review / 中国实验方剂学杂志

ObjectiveThis study performed a scoping review to comprehensively analyze and report the information on the instructions of Chinese patent medicines and clinical research evidence for the treatment of respiratory diseases in children. MethodChinese patent medicines against respiratory diseases in children were obtained by searching the three major drug catalogues. The Chinese and English databases were searched for relevant literature，followed by data statistics and visualized analysis. ResultAfter screening and analysis，52 Chinese patent medicines were included，involving nine dosage forms. The main drugs were Scutellariae Radix，Armeniacae Semen Amarum，Forsythiae Fructus，etc. The main functions included clearing heat and releasing exterior syndrome，and relieving cough and dissipating phlegm. The indications mainly included common cold with wind-heat syndrome and cough in children. Adverse drug reactions and contraindications were only specified in 19.23% （10/52） of Chinese patent medicines，and the rest only displayed "unclear". A total of 279 articles were included，including 277 articles from Chinese Core Periodicals and two articles from SCIE. In terms of research type，those articles included 253 randomized controlled trials （RCTs，with six dosage form/dose comparisons involved），11 retrospective analyses based on Hospital Information System （HIS） data，one case series，13 systematic reviews/Meta-analyses （with two network Meta-analyses involved），and one economic evaluation article. Among them，72.76% （203/279） of the articles were published in the Core Journals of Chinese Science and Technology. Only 33 Chinese patent medicines were involved，and Xiaoer Feire Kechuan Oral Liquid was the top 1 under investigation，accounting for 15.71% （44/280）. The indicated diseases were mainly infantile pneumonia，bronchitis，respiratory tract infection，cough，asthma，and other western medicine diseases. Xiaoer Chiqiao Qingre Granules and Xiaoer Dingchuan Oral Liquid were used off-label. The sample size was concentrated in 51-150 cases，accounting for 67.17% （178/265）. The interventions in the experimental group were mainly Chinese patent medicine + western medicine + basic treatment or Chinese patent medicine + western medicine. The main outcomes were the effective rate and the improvement of clinical symptoms. The adverse reactions were mainly gastrointestinal reactions，drug-induced skin symptoms，etc.，and two studies have shown that drug doses were associated with adverse reactions. ConclusionIn research years，the research on Chinese patent medicines in the treatment of respiratory diseases in children has advanced rapidly. However，there are still some problems that need to be resolved in the future，such as incomplete information on drug content in the instruction，concentrated drugs to be studied，limited indications，failure to highlight the characteristics of traditional Chinese medicine （TCM） syndromes，unstandardized research design，and an incomplete reflection of Chinese patent medicine.

Eucaliptol: una vista de la medicina tradicional en el siglo xxi

El Eucalyptus spp (eucalipto) es un árbol de la familia myrtaceae con diferentes propiedades y usos. El objetivo es conocer las propiedades terapéuticas del aceite de hojas de Eucalyptus globulus y Eucalyptus camaldulensis frente a enfermedades respiratorias. Por ello, se realizó una búsqueda sistemática con lenguaje controlado en artículos de gran relevancia sobre el tema en metabuscadores científicos. La investigación fue viable debido a la presencia de estudios de libre acceso relacionados a las propiedades medicinales del aceite de E. globulus y E. camaldulensis, se comprobó los efectos antifúngicos, antivirales y antibacteriales; y si sus intervenciones son positivas en cuanto a la mejoría de enfermedades de vía respiratoria. Se concluyó que las propiedades medicinales del eucaliptol de E. globulus y E. camaldulensis son beneficiosas para la enfermedad pulmonar obstructiva crónica, asma, para síntomas del COVID-19 e incluso para pacientes con ventilación mecánica.

Eucalyptus spp is a tree of the myrtaceae family with different properties and uses. The objective is to know the therapeutic properties of Eucalyptus globulus and Eucalyptus camaldulensis leaf oil against respiratory diseases. Therefore, a systematic search was carried out with controlled language in articles of great relevance on the subject in scientific meta-search engines. The research was feasible due to the presence of open access studies related to the medicinal properties of E. globulus and E. camaldulensis oil, the antifungal, antiviral and antibacterial effects were tested; and if their interventions are positive in terms of improvement of respiratory tract diseases. It was concluded that the medicinal properties of eucalyptol from E. globulus and E. camaldulensis are beneficial for chronic obstructive pulmonary disease, asthma, COVID-19 symptoms and even for patients on mechanical ventilation.

A Síndrome Respiratória Aguda Grave na pessoa idosa no contexto da pandemia da covid-19 e seus fatores associados / Severe Acute Respiratory Syndrome in older adults amid the COVID-19 pandemic and associated factors

Resumo A Síndrome Respiratória Aguda Grave (SRAG) constitui-se como uma das doenças respiratórias mais preocupantes, sendo caracterizada por um quadro gripal associado à taquipneia ou à hipoxemia e saturação inferior a 95% em ar ambiente. No contexto da pandemia do novo coronavírus (SARS-CoV-2) observou-se um crescimento exponencial nos casos sendo a pessoa idosa o grupo populacional mais afetado. Diante do exposto, este estudo teve como objetivo descrever os casos de SRAG, assim como os fatores sociodemográficos e de saúde associados ao óbito na população idosa de um município do norte do estado do Rio Grande do Sul, Brasil. Trata-se de um estudo epidemiológico, realizado a partir da análise de dados do Sistema de Informação de Vigilância Epidemiológica da Gripe. As informações foram disponibilizadas pela Secretaria Municipal de Saúde do município de Passo Fundo entre 01 de janeiro a 31 de dezembro de 2020. A estatística descritiva compreendeu a distribuição das frequências absolutas (n) e relativas (%) das variáveis de interesse. Na análise dos fatores associados estimouse razões de odds brutas e ajustadas por meio da Regressão Logística. Foi observado um total de 1.268 notificações por SRAG em idosos, sendo 72% causadas pela covid-19. A letalidade observada foi alta (40,9%), principalmente entre homens e de baixa escolaridade, sendo a presença de algum fator de risco determinante para o óbito, destacando-se a doença renal crônica. Espera-se que as associações evidenciadas neste trabalho possam auxiliar nas políticas de saúde direcionadas à saúde da pessoa idosa, sobretudo pelo fortalecimento das ações na rede de atenção primária.

Abstract Severe Acute Respiratory Syndrome (SARS) is one of the most worrying respiratory diseases, characterized by a flu-like condition associated with tachypnea or hypoxemia, with saturation below 95% in ambient air. In the context of the new coronavirus (SARSCoV- 2) pandemic, exponential growth in cases was observed, with the elderly being the most affected population group. This study aimed to describe SARS cases, as well as socio-demographic and health-associated factors in the elderly population of a city in the north of Rio Grande do Sul state, Brazil. This is an epidemiological study carried out by Influenza Epidemiological Surveillance Information System. The information was made available by the Municipal Health Department of the Passo Fundo between January 1st and December 31st, 2020. In the descriptive analysis, the distribution of absolute (n) and relative (%) frequencies of the variables of interest was performed. Crude and adjusted odds ratios were estimated using Logistic Regression. A total of 1,268 SARS notifications were observed in the elderly, 72% of which were caused by covid-19. The lethality was high (40.9%), mainly among men and those with low education, with the presence of at least one risk factor, especially chronic kidney disease. It is expected that the associations highlighted in this study can help to develop health policies aimed at the health of the elderly, especially by strengthening actions in primary health care.

Probability of premature mortality due to four chronic diseases in Jiangmen City from 2012 to 2021 / 预防医学

Objective@#To investigate the mortality of malignant tumors, diabetes, cardio-cerebrovascular diseases and chronic respiratory diseases and trends in probability of premature mortality due to these four chronic diseases in Jiangmen City, Guangdong Province from 2012 to 2021, so as to provide the evidence for perfecting the chronic disease control strategy. @*Methods@#The mortality of malignant tumors, diabetes, cardio-cerebrovascular diseases and chronic respiratory diseases among household registered residents in Jiangmen City from 2012 to 2021 were collected from the Guangdong Provincial Population Death Information Registration Management System, and the crude mortality, standardized mortality by the population of the Fifth National Population Census in China in 2000 and probability of premature mortality were calculated. The trends in mortality and probability of premature mortality were analyzed using average annual percent change (AAPC), and whether achieving the targets for the probability of premature mortality due to four chronic diseases in 2025 and 2030 were evaluated.@*Results@#A total of 226 012 deaths occurred due to four chronic diseases in Jiangmen City from 2012 to 2021, and the overall crude mortality and standardized mortality rates were 569.22/105 and 283.29/105, with a reduction in the probability of premature mortality from 15.04% to 12.05% (AAPC=-2.403%, Z=-7.603, P<0.001). The probability of premature mortality due to four chronic diseases decreased from 19.21% to 16.38% in males, and from 10.42% to 7.58% in females (AAPC=-1.893% and -3.085%, Z=-5.262 and -9.811, both P<0.001). The probability of premature mortality due to diabetes appeared a tendency towards a rise (AAPC=2.317%, Z=2.548, P=0.034), and the probability of premature mortality due to cardio-cerebrovascular diseases showed a tendency towards a decline (AAPC=-4.826%, Z=-13.590, P<0.001), while no significant changing trend was seen in the probability of premature mortality due to malignant tumors or chronic respiratory diseases (AAPC=-0.751% and -2.461%, Z=-1.532 and -1.730, P=0.125 and 0.122). The predicted probability of premature mortality due to four chronic diseases was 10.92% in 2025 and 9.66% in 2030 in Jiangmen City, which were both lower than the target (11.21% and 9.81%). @*Conclusions@#The probability of premature mortality due to four chronic diseases appeared a tendency towards a decline in Jiangmen City from 2012 to 2021, which can reach the target in 2025 and 2030. Males should be given a high priority for interventions of chronic diseases, and diabetes control should be reinforced.

La Huamanripa (Senecio tephrosioides Turcz) como alternativa saludable para afecciones respiratorias durante la pandemia COVID-19 / Huamanripa (Senecio tephrosioides Turcz) as a healthy alternative for respiratory conditions during the COVID-19 pandemic / Huamanripa (Senecio tephrosioides Turcz) como alternativa saudável para problemas respiratórios durante a pandemia de COVID-19

Desde tiempo histórico las plantas medicinales se han empleado como ingrediente principal para preparación de diferentes recetas. Motivo que se investigó sobre la Huamanripa como alternativa saludable para afecciones respiratorias durante la pandemia COVID-19 en Barranca. Objetivo. El objetivo fue determinar la eficiencia de la Huamanripa como alternativa saludable para las afecciones respiratorias en la pandemia. Materiales y Método. La metodología se basa en investigación descriptiva con enfoque cuantitativo prospectivo, por lo que se cuestionó sobre la preparación, frecuencia de consumo y para que enfermedades se consumen. Obtenidos los datos se procesaron mediante estadísticas básicas y regresión. Resultados. Se determinó que la Huamanripa lo usan para tratamiento casero medicinal y consume con frecuencia 4 a 5 veces por semana para afecciones respiratorias y COVID-19, consumo de Huamanripa por mes con 23 % de la población, porcentaje de alivio de afecciones respiratorias con 84 %, correlación entre el consumo de Huamanripa y porcentaje de alivio r = 0.99 y en análisis de varianza del consumo de Huamanripa y el porcentaje de alivio no hubo significancia. Conclusiones. Concluye que la Huamanripa es una alternativa eficiente y se puede complementar con otros tratamientos para las afecciones respiratorias y síntomas de COVID-19; ya sea por sus propiedades como aceites especiales y terpenos que tienen efectos antimicrobiana, antiinflamatoria, aliviante, lo cual favorece a la salud.

Since historical times, medicinal plants have been used as the main ingredient for the preparation of different recipes. For this reason, Huamanripa was investigated as a healthy alternative for respiratory diseases during the COVID-19 pandemic in Barranca. Objective. The objective was to determine the efficiency of Huamanripa as a healthy alternative for respiratory diseases during the pandemic. Materials and Method. The methodology is based on descriptive research with a prospective quantitative approach, so that the preparation, frequency of consumption and the diseases for which it is consumed were questioned. Data were obtained and processed by means of basic statistics and regression. Results. It was determined that Huamanripa is used for medicinal home treatment and consumed 4 to 5 times a week for respiratory diseases and COVID-19, consumption of Huamanripa per month with 23% of the population, percentage of relief of respiratory diseases with 84%, correlation between consumption of Huamanripa and percentage of relief r = 0.99 and in variance analysis of Huamanripa consumption and percentage of relief there was no significance. Conclusions. It is concluded that Huamanripa is an efficient alternative and can be complemented with other treatments for respiratory conditions and symptoms of COVID-19; either by its properties such as special oils and terpenes that have antimicrobial, anti-inflammatory, relieving effects, which favors health.

Desde tempos históricos as plantas medicinais têm sido utilizadas como ingrediente principal para a preparação de diferentes receitas. Por esta razão, Huamanripa foi investigado como uma alternativa saudável para doenças respiratórias durante a pandemia da COVID-19 em Barranca. Objetivo. O objetivo era determinar a eficiência de Huamanripa como uma alternativa saudável para as doenças respiratórias durante a pandemia. Materiais e Método. A metodologia é baseada em pesquisa descritiva com uma abordagem quantitativa prospectiva, de modo que foram feitas perguntas sobre a preparação, a freqüência do consumo e para quais doenças é consumida. Os dados foram obtidos e processados utilizando estatísticas básicas e regressão. Resultados. Foi determinado que Huamanripa é usado para tratamento medicinal domiciliar e consumido 4 a 5 vezes por semana para doenças respiratórias e COVID-19, consumo de Huamanripa por mês com 23% da população, porcentagem de alívio de doenças respiratórias com 84%, correlação entre consumo de Huamanripa e porcentagem de alívio r = 0,99 e na análise de variância do consumo de Huamanripa e da porcentagem de alívio não houve significância. Conclusões. Conclui que Huamanripa é uma alternativa eficiente e pode ser complementada com outros tratamentos para condições respiratórias e sintomas da COVID-19; seja por suas propriedades como óleos especiais e terpenos que têm efeitos antimicrobianos, anti-inflamatórios, aliviadores, o que favorece a saúde.

Sintomas de ansiedade e depressão em pacientes com doenças respiratórias internados em um hospital público / Symptoms of anxiety and depression in inpatients with respiratory diseases staying in a public hospital / Síntomas de ansiedad y depresión en pacientes con enfermedades respiratorias ingresados en un hospital público

Doenças respiratórias representam uma das principais causas de morbidade e mortalidade a nível global. O acometimento patológico das vias aéreas aumenta os riscos de transtornos psiquiátricos, devido às inúmeras admissões hospitalares e à dependência de cuidados médicos e pessoais. O presente artigo pretendeu identificar a prevalência de sintomas de ansiedade e depressão em pacientes com doenças respiratórias em um hospital público de Salvador (BA), assim como avaliar os fatores possivelmente associados à sintomatologia ansiosa e depressiva nesses pacientes. Para isso, realizou-se estudo observacional, descritivo e de corte transversal, que ocorreu no Hospital Especializado Octávio Mangabeira (HEOM). Foi utilizada uma amostra de conveniência de 140 pacientes assistidos no período de outubro de 2018 a janeiro de 2019. Os participantes responderam aos seguintes instrumentos: questionário clínico, demográfico e socioeconômico; Escala Hospitalar de Ansiedade e Depressão (HADS); e o Teste de Dependência à Nicotina de Fagerstrom (FTND). Para a análise de dados, optou-se pelo Teste Exato de Fisher, concluindo-se que a prevalência de prováveis sintomas ansiosos e depressivos foi de 35,7% e 31,4% respectivamente. As variáveis significativas (p < 0,05) encontradas no estudo foram: sexo, estado civil, renda familiar e asma. Os achados desta pesquisa apontam para a importância de se avaliar a presença dos sintomas de ansiedade e depressão para melhorar o prognóstico e a qualidade de vida dos pacientes, além da adesão ao tratamento da patologia respiratória.

Respiratory diseases represent one of the main causes of morbidity and mortality worldwide. The pathological involvement of the airways increases the risks of psychiatric disorders, due to the numerous hospital admissions and the dependence on medical and personal care. This article aimed to identify the prevalence of symptoms of anxiety and depression in patients with respiratory diseases in a public hospital in Salvador, Bahia, as well as to evaluate the factors possibly associated with anxious and depressive symptoms in these patients. To that end, an observational, descriptive, and cross-sectional study, which took place at the Hospital Especializado Octávio Mangabeira (HEOM), was conducted. A convenience sample of 140 patients assisted from October 2018 to January 2019 was used. Participants answered the following instruments: clinical, demographic and socioeconomic questionnaire; Hospital Anxiety and Depression Scale (HADS); and the Fagerstrom Test for Nicotine Dependence (FTND). For data analysis, Fisher's exact test was chosen reaching a prevalence of probable anxious and depressive symptoms of 35.7% and 31.4%, respectively. The significant variables (p < 0.05) found in the study were: sex, marital status, family income, and asthma. The findings of this research point to the importance of assessing the presence of symptoms of anxiety and depression to improve the prognosis and quality of life of patients, in addition to the adherence to the treatment of the respiratory pathology.

Las enfermedades respiratorias son una de las principales causas de morbilidad y mortalidad a nivel mundial. La afectación patológica de las vías respiratorias aumenta los riesgos de trastornos psiquiátricos, debido a los numerosos ingresos hospitalarios y a la dependencia de la atención médica y personal. Este artículo pretendió identificar la prevalencia de los síntomas de ansiedad y depresión en pacientes con enfermedades respiratorias en un hospital público de Salvador, en Bahía (Brasil), así como evaluar los factores posiblemente asociados a los síntomas ansiosos y depresivos en estos pacientes. Para ello, se realizó un estudio observacional, descriptivo y transversal en el Hospital Especializado Octávio Mangabeira (HEOM). Participó una muestra de conveniencia de 140 pacientes atendidos desde octubre de 2018 a enero de 2019. Los participantes respondieron los siguientes instrumentos: cuestionario clínico, demográfico y socioeconómico; Escala Hospitalaria de Ansiedad y Depresión (HADS); y la prueba de dependencia a la nicotina de Fagerstrom (FTND). Para el análisis de datos, se eligió la prueba exacta de Fisher; y se concluye que la prevalencia de probables síntomas ansiosos y depresivos fue del 35,7% y el 31,4%, respectivamente. Las variables significativas (p < 0,05) encontradas en el estudio fueron: sexo, estado civil, ingresos familiares y asma. Los hallazgos de esta investigación apuntan a la importancia de evaluar la presencia de síntomas de ansiedad y depresión para mejorar el pronóstico y la calidad de vida de los pacientes, además de la adherencia al tratamiento de la patología respiratoria.

Cánula Nasal de Alto Flujo en Adultos con Enfermedades Respiratorias Crónicas durante el Ejercicio Físico: Protocolo de Revisión Sistemática y Metaanálisis / High-Flow Nasal Cannula in Adults with Chronic Respiratory Diseases during Physical Exercise: A Protocol Systematic Review and Meta-analysis

Introducción. El entrenamiento físico puede mejorar la capacidad de ejercicio, la disnea y la calidad de vida (CV) en pacientes con enfermedades respiratorias crónicas (ERC). En este contexto, el uso de oxígeno suplementario a través de una cánula nasal de alto flujo (CNAF) podría ser un dispositivo que permita tolerar mayores niveles de actividad con menos síntomas de esfuerzo físico, optimizando en última instancia la capacidad de ejercicio y la CV. Objetivo. Este protocolo pretende conducir una revisión sistemática para evaluar el efecto terapéutico de la CNAF durante el ejercicio físico en pacientes con ERC. Fuente de búsqueda. Se realizarán búsquedas en el Registro Cochrane Central de Ensayos Controlados (CENTRAL), PUBMED, Embase, Lilacs, Physiotherapy Evidence Database (PEDro), International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov y literatura gris. Criterios de elegibilidad. Examinaremos los ECA de acuerdo con los criterios de elegibilidad para su inclusión en nuestra revisión. Dos revisores examinarán de forma independiente cada estudio para la elegibilidad, la extracción de datos y la evaluación del riesgo de sesgo. Se combinarán los resultados mediante un metanálisis y se aplicará el sistema GRADE para evaluar la certeza de las pruebas para cada resultado. La medida de resultado primaria será la capacidad de ejercicio, y las medidas de resultado secundarias serán la calidad de vida, la disnea, la funcionalidad, la comodidad, las complicaciones y adherencia. Se realizarán metaanálisis para determinar la diferencia de medias (DM) o la DM estandarizada para los datos continuos y la razón de riesgo para los datos dicotómicos. Se realizarán análisis de subgrupos según los tipos y la gravedad de la enfermedad, las condiciones de ejercicio físico y el estado de los dispositivos de oxigenoterapia. Ética y difusión. Como los investigadores no accederán a información que pueda conducir a la identificación de un participante individual, no fue necesario a obtener aprobación ética. Número de registro de PROSPERO: CRD42022336263.

Background. Physical training can improve exercise capacity, dyspnoea, and quality of life (QoL) in patients with chronic respiratory diseases (CRDs). It has been suggested that using supplemental oxygen through a high-flow nasal cannula (HFNC) could lead to higher levels of activity to be tolerated with fewer symptoms of physical exertion, ultimately optimizing exercise capacity and QoL. Objective. To conduct a systematic review to assess the therapeutic effect of HFNC during physical exercise in patients with CRDs. We will search the Cochrane Central Register of Controlled Trials (CENTRAL), PUBMED, Embase, Lilacs, Physiotherapy Evidence Database (PEDro), International Clinical Trials Registry Platform (ICTRP), ClinicalTrials.gov, and grey literature. Eligibility criteria. We will examine RCTs according to the eligibility criteria for inclusion in our review. Two reviewers will independently examine each study for eligibility, data extraction, and risk of bias assessment. We will combine the results using meta-analysis and apply the GRADE system to assess the certainty of the evidence for each outcome. The primary outcome will be exercise capacity, and secondary outcomes will be QoL, dyspnoea, functionality, comfort, complications, and adherence. We will perform meta-analyses to determine the mean difference (MD) or standardized MD for continuous data and the risk ratio for dichotomous data. Subgroup analyses will be performed according to types and severity of disease, physical exercise conditions, and condition of oxygen therapy devices. Ethics and Dissemination. As researchers will not access information that could lead to the identification of an individual participant, obtaining ethical approval was waived. Prospero registration number: CRD42022336263.

Seasonal variations in daily mortality associated with exposure to particulates, in Campo Grande, Brazil / Variaciones estacionales de la mortalidad diaria asociada a la exposición a partículas, en Campo Grande, Brasil / Variações sazonais na mortalidade diária associada à exposição a partículas, em Campo Grande, Brasil

Obcjetive: to investigate short-term effects of air pollution, climate variability on respiratory morbidity and mortality from 2005 to 2020. Method: the study was carried out in the city of Campo Grande, Mato Grosso do Sul, Brazil. Daily counts of hospital admissions from 2005 to 2020 were analyzed in relation to daily variations in atmospheric pollutants (NO2, O3) from the Aurea satellite column, OMI sensor. Poisson regression in generalized additive models was used for analysis. The models were adjusted for the effects of temporal trend, seasonality, meteorological factorsand autocorrelation. Results: there was, in the period, an increasing trend in mortality rates and hospital admissions, with an increase in the proportion of deaths from respiratory diseases in relation to other causes. Conclusion: respiratory diseases are worrying causes of hospitalization and death in the population. The results found are consistent with studies that point to an association between short-term variations in air pollutants and the increase in morbidity and mortality in large urban centers.

Objetivo:investigar los efectos a corto plazo de lacontaminación del aire, la variabilidad climática en la morbilidad y mortalidad respiratoria de 2005 a 2020. Método:el estudio se llevó a cabo en la ciudad de Campo Grande, Mato Grosso do Sul, Brasil. Se analizaron los conteos diarios de ingresos hospitalarios de 2005 a 2020 en relación con las variaciones diarias de contaminantes atmosféricos (NO2, O3) de la columna del satélite Aurea, sensor OMI. Para el análisis se utilizó la regresión de Poisson en modelos aditivos generalizados. Los modelos fueron ajustados por los efectos de tendencia temporal, estacionalidad, factores meteorológicos y autocorrelación. Resultados:hubo, en el período, una tendencia creciente en las tasas de mortalidad e ingresos hospitalarios, con aumento en la proporción de muertes por enfermedades respiratorias en relación a otras causas. Conclusión:las enfermedades respiratorias son causas preocupantesde hospitalización y muerte en la población. Las acciones de prevención y atención de estas causas, así como la profundización de la investigación etiológica, deben ser priorizadas en el actual contexto epidemiológico de salud en Brasil. Los resultados encontrados son consistentes con estudios que apuntan a una asociación entre las variaciones a corto plazo de los contaminantes atmosféricos y el aumento de la morbilidad y mortalidad en los grandes centros urbanos.

Objetivo:investigar os efeitos a curto prazo da poluição do ar, variabilidade climática na morbimortalidade respiratória entre os anos de 2005 a 2020. Método: o estudo foi realizado na cidade de Campo Grande, Mato Grosso do Sul, Brasil. As contagens diárias de internações hospitalares entre os anos de 2005 a 2020 foram analisadas em relação às variações diárias de poluentes atmosféricos (NO2, O3) da coluna satélite Aurea, sensor OMI. A regressão de Poisson em modelos aditivos generalizados foi utilizada para análise. Os modelos foram ajustados pelos efeitos de tendência temporal, sazonalidade, fatores meteorológicos e autocorrelação. Resultados: houve, no período, tendência crescente nas taxas de mortalidade e internações hospitalares, com aumento da proporção de óbitos por doenças respiratórias em relação a outras causas. Conclusão: as doenças respiratórias são causas preocupantes de hospitalização e morte na população. Ações de prevenção e atenção a essas causas, bem como a investigação etiológica , devem ser priorizadas no atual contexto epidemiológico da saúde no Brasil. Os resultados encontrados são consistentes com estudos que apontam para uma associação entre as variações de curto prazo dos poluentesatmosféricos e o aumento da morbimortalidade nos grandes centros urbanos.

Dietary Habits and Nutritional Status among Preschool Children: An Observational Study at Bagalkot

Background: Knowing what eating habits are associated with a child's development can lead to better long-term health outcomes and improve dietary design interventions. We aimed to identify eating habits associated with the nutritional status of children between 3-6 years living in Chilapur Village of Bagalkot District. Methods: Dietary habits of preschool children were assessed with the aid of a structured score scale in an interview of mothers and fathers of preschool children. Anthropometric measurements like weight, height and mid-arm circumference have been taken to decide the nutritional status of preschool kids with help of Z rating received via WHO Anthro software. Results: Findings of the study reveals that 68% of preschool children had moderate dietary habits and 28% of them had poor eating habits and 4% of them had good eating habits. Nutritional Status assessed through anthropometric measurements shows that 39% of preschool children had moderate nutritional status according to their weight for age (?-2 to +2 Score), 51% of preschool children had moderate nutritional status according to their height for age (?-2 to +2 Score), and 48% of pre-school children had moderate nutritional status according to their Weight for height (?-2 to +2 z score). A significant association was found between Dietary habits and Weight for age (?2 =8.69, p<0.05), Weight for height (?2 =9.12, p<0.05). A significant association was found between dietary habits and Family monthly income (?2=10.58, p<0.05). Conclusion: Nutritional status of children aged between 3�years is of great health concern in India. A better nutritional diversity and meals variety and dietary styles characterized by intake of protein and calorie-rich diet seem beneficial for the growth of younger kids.

Impacto das mudanças climáticas e da qualidade do ar em hospitalizações por doenças respiratórias em municípios da Região Metropolitana de São Paulo (RMSP), Brasil / Impact of climate change and air quality on hospitalizations for respiratory diseases in municipalities in the Metropolitan Region of São Paulo (MRSP), Brazil

Resumo Este estudo teve por objetivo analisar os possíveis impactos das mudanças climáticas na saúde respiratória nos municípios de Santo André e São Caetano do Sul. Foram analisados dados meteorológicos históricos (temperatura, precipitação, umidade relativa e pressão atmosférica), de qualidade do ar (concentrações de MP10 e O3) e de saúde respiratória (taxas de incidência de internações por doenças respiratórias - TIIDR), relacionados através de modelos estatísticos de Regressão Linear Múltipla (RLM). Dados meteorológicos de projeções climáticas futuras (2019-2099) de três modelos climáticos (um global e dois regionalizados) em dois cenários de emissão foram aplicados aos modelos de RLM. Os resultados das projeções mostraram um aumento de até 10% nas TIIDR em relação aos níveis atuais para São Caetano do Sul no período de 2070-2099. Em Santo André as projeções indicaram redução de até 26% nas TIIDR. A variável de maior peso nos modelos de RLM de Santo André foi a temperatura (-2,15x) indicando que o aquecimento é inversamente proporcional ao aumento nas TIIDR, enquanto em São Caetano do Sul a pressão atmosférica teve o maior peso (2,44x). Para próximos trabalhos recomenda-se a inclusão de projeções futuras de concentrações de poluentes atmosféricos.

Abstract The scope of this study was to analyze the possible impacts of climate change on respiratory health in the municipalities of Santo André and São Caetano do Sul. Historical meteorological data (temperature, precipitation, relative humidity and atmospheric pressure), air quality data (concentrations of PM10 and O3) and respiratory health data (incidence rates of hospitalizations for respiratory diseases - IRHRD) were related through statistical models of Multiple Linear Regression (MLR). Meteorological data from future climate projections (2019-2099) from three different climate models (one global and two regionalized) in two emission scenarios were applied to the MLR models. The results showed that the IRHRD will suffer an increase of up to 10% in relation to the current levels for São Caetano do Sul in the 2070-2099 period. In Santo André, projections indicated a reduction of up to 26% in IRHRD. The most important variable in the MLR models for Santo André was temperature (-2,15x), indicating an inverse relationship between global warming and an increase in IRHRD, while in São Caetano the atmospheric pressure had the greatest weight (2.44x). For future studies, the inclusion of future projections of PM10 concentrations is recommended.

Atención odontológica bajo sedación endovenosa (R2) en niños hospitalizados con enfermedades respiratorias crónicas

RESUMEN: El Hospital Josefina Martínez está especializado en atención de niños con enfermedades respiratorias crónicas. En él hemos implementado un modelo de atención odontológica, bajo sedación endovenosa, monitorización cardiorespiratoria con participación de un equipo multidisciplinario. Objetivos: Describir la atención odontológica en pacientes hospitalizados con enfermedades respiratorias crónicas. Identificar las patologías bucales más prevalentes y los tratamientos realizados. Material y Método: El estudio se realizó incluyendo las atenciones odontológicas bajo sedación endovenosa, entre los años 2014-2016, considerando a 18 pacientes hospitalizados. Todos recibieron sedación y analgesia con Midazolam-Ketamina con monitorización continua no invasiva durante el procedimiento. Resultados: Se encontró una alta prevalencia de gingivitis, anomalías dentomaxilares y patologías de erupción. La lesión de caries tuvo baja prevalencia. Los tratamientos realizados fueron: profilaxis, destartarje, aplicación de barniz de clorhexidina y/o flúor, exodoncias, exposición quirúrgica de dientes y restauraciones. Conclusiones: Es importante mostrar nuestra experiencia, ya que hemos realizado tratamientos en forma oportuna, eficiente y de bajo costo, mejorando la salud bucal de los niños. Además fueron atendidos sin necesitar traslado a otro centro de salud, permitiendo resolver las urgencias y la atención odontológica integral de los pacientes.

ABSTRACT: The Josefina Martínez Hospital specializes in the care of children with chronic respiratory diseases. There, we implemented a model of dental care under intravenous sedation and cardiorespiratory monitoring, with the participation of a multidisciplinary team. Objective: Describe dental care in hospitalized patients with chronic respiratory diseases. Identify the most prevalent oral diseases and the treatments performed. Materials and Methodology: The study was conducted including dental care under intravenous sedation, between 2014 and 2016, considering 18 hospitalized patients. All received sedation and analgesia with Midazolam-Ketamine with continuous non-invasive monitoring during the procedure. Results: A high prevalence of gingivitis, dentomaxillary abnormalities and eruption disorders was found. Caries lesion had a low prevalence. The treatments performed were: prophylaxis, scaling, application of chlorhexidine and / or fluoride varnish, extractions, surgical exposure of teeth and restorations. Conclusion: It is important to show our experience, since we have made timely, efficient and low cost treatments, improving the oral health of children. In addition, they were attended without requiring the transfer to other health centers, which allowed to meet the emergencies and the comprehensive dental care of the patients.

Relación de PM2, 5 y Enfermedad Respiratoria Aguda en un territorio de Colombia: Modelos Aditivos Generalizados / Relationship between PM2. 5 and Acute Respiratory Disease in a Colombian region: Generalized Additive Models

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.

Prevalence of chronic respiratory diseases and medication use among children and adolescents in Brazil - a population based cross-sectional study / Prevalência de doenças respiratórias crônicas e uso de medicamentos entre crianças e adolescentes no Brasil - um estudo transversal de base populacional

Abstract Objectives: to describe the prevalence of chronic respiratory diseases and their pharmacological management in children and adolescents in Brazil. Methods: data from the Pesquisa Nacional de Acesso, Uso e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM)(National Access Survey, Use and Promotion of Rational Use of Medicines in Brazil),a population-based cross-sectional study, were analyzed. Household surveys were conducted between September 2013 and February 2014. We included the population under 20 years of age with chronic respiratory diseases. Prevalence of disease, indication of pharmacological treatment, and their use were assessed. Results: the prevalence of chronic respiratory diseases in children aged less than 6 years old was 6.1% (CI95%= 5.0-7.4), 4.7% (CI95%= 3.4-6.4) in those 6-12 years, and 3.9% (CI95%= 2.8-5.4) in children 13 years and older. Children under 6 showed a higher prevalence of pharmacological treatment indication (74.6%; CI95%= 66.0-81.7), as well as medication use (72.6%; CI95%= 62.8-80.7). Of those using inhalers, 56.6% reported using it with a spacer. The most frequent pharmacologic classes reported were short-acting β2 agonists (19.0%), followed by antihistamines (17.2%). Conclusion: children and adolescents who report chronic respiratory diseases living in urban areas in Brazil seem to be undertreated for their chronic conditions. Pharmacological treatment, even if indicated, was not used, an important finding for decision-making in this population.

Resumo Objetivos: descrever a prevalência de doenças respiratórias crônicas e seu manejo farmacológico em crianças e adolescentes no Brasil. Métodos: foram analisados os dados da Pesquisa Nacional de Acesso, Uso e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM), um estudo transversal de base populacional. As pesquisas domiciliares foram realizadas entre setembro de 2013 e fevereiro de 2014. Incluímos a população com menos de 20 anos de idade com doenças respiratórias crônicas. Foi avaliada a prevalência de doença, indicação de tratamento farmacológico e seu uso. Resultados: a prevalência de doenças respiratórias crônicas em menores de 6 anos foi de 6,1% (IC95%= 5,0-7,4), 4,7% (IC95%= 3,4-6,4) naqueles 6-12 anos e 3,9% (IC95%= 2,8-5,4) em crianças com 13 anos ou mais. Crianças menores de 6 anos apresentaram uma maior prevalência de indicação de tratamento farmacológico (74,6%; IC95%= 66,0-81,7), assim como uso de medicamentos (72,6%; IC95%= 62,8-80,7). Dos usuários de inaladores, 56,6% relataram o uso com espaçador. As classes farmacológicas mais frequentemente relatadas foram β2 agonistas de curta ação (19,0%), seguidos por anti-histamínicos (17,2%). Conclusão: crianças e adolescentes que relatam doenças respiratórias crônicas residentes em áreas urbanas no Brasil parecem ser subtratados para suas condições crônicas. O tratamento farmacológico, mesmo quando indicado, não foi utilizado em sua totalidade, um achado importante para a tomada de decisão nessa população.

Adverse early-life environmental exposures and their repercussions on adult respiratory health

Abstract Objective: To review in the literature the environmental problems in early life that impact the respiratory health of adults. Sources: Non-systematic review including articles in English. Search filters were not used in relation to the publication date, but the authors selected mainly publications from the last five years. Summary of the findings: In this review, the authors present the exposure pathways and how the damage occurs depending on the child's stage of development; the authors describe the main environmental pollutants - tobacco smoke, particulate matter, air pollution associated with traffic, adverse childhood experiences and socioeconomic status; the authors present studies that evaluated the repercussions on the respiratory system of adults resulting from exposure to adverse environmental factors in childhood, such as increased incidence of Chronic Obstructive Pulmonary Disease (COPD), asthma and allergies; and, a decline in lung function. The authors emphasize that evidence demonstrates that adult respiratory diseases almost always have their origins in early life. Finally, the authors emphasize that health professionals must know, diagnose, monitor, and prevent toxic exposure among children and women. Conclusion: The authors conclude that it is necessary to recognize risk factors and intervene in the period of greatest vulnerability to the occurrence of harmful effects of environmental exposures, to prevent, delay the onset or modify the progression of lung disease throughout life and into adulthood.