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1.
Arch. argent. pediatr ; 118(2): 89-: I-94, II, abr. 2020. tab, ilus
Artigo em Inglês, Espanhol | LILACS (Américas), BINACIS | ID: biblio-1099856

RESUMO

Introducción. La fiebre en pediatría es motivo de consulta frecuente. El objetivo fue evaluar los conocimientos, actitudes y temores de los padres ante la fiebre de sus hijos.Material y métodos. Estudio observacional, analítico, transversal. En 2018, se realizó una encuesta a padres de niños de entre 6 meses y 5 años que asistieron al Hospital de Niños Ricardo Gutiérrez de la Ciudad de Buenos Aires.Se analizó la asociación entre las variables sociodemográficas y los conocimientos, actitudes y temores frente al cuadro febril.Resultados. Se realizaron 201 encuestas. El 56,7 % de los padres consideró que la fiebre era mala para la salud. El 37 % definió fiebre entre 37 °C y 37,5 °C, y el 59 %, 38-38,5 ºC. La media de temperatura considerada grave fue 39,2 °C (desvío estándar 0,69). El 93 % de los cuidadores utilizaba medidas físicas; el 97 % administraba antitérmicos y el 14,5 % los alternaba. Los temores a las consecuencias fueron, en el 82 %, convulsiones; en el 41 %, deshidratación; en el 18 %, daño cerebral y, en el 12 %, muerte. El 86,5 % despertaba a sus hijos para administrarles antitérmico. En el estrato de mayor instrucción materna, fue menor el temor a la fiebre (odds ratio0,5; intervalo de confianza del 95 %: 0,28-0,91).Conclusiones. Un tercio de los encuestados consideró fiebre valores bajos de temperatura. El temor a la fiebre fue elevado y el nivel de instrucción materna podría mitigarlo.


Introduction. In pediatrics, fever is a common reason for consultation. The objective was to assess parental knowledge, behaviors, and fears in the management of fever in their children.Materials and methods. Observational, analytical, cross-sectional study. In 2018, a survey was administered to the parents of children aged 6 months to 5 years who attended Hospital de Niños Ricardo Gutiérrez, in the Autonomous City of Buenos Aires. The association between sociodemographic outcome measures and knowledge, behaviors, and fears in cases of fever was analyzed.Results. A total of 201 surveys were completed: 56.7 % of parents considered that fever was bad for health; 37 % defined fever between 37 °C and 37.5 °C, and 59 %, between 38 °C and 38.5 °C. The mean temperature considered severe was 39.2 °C (standard deviation: 0.69). Physical methods were used by 93 % of caregivers; 97 % administered antipyretic agents, and 14.5 % used alternating agents. Fears of consequences included seizures in 82 %, dehydration in 41 %, brain damage in 18 %, and death in 12 %. Also, 86.5 % woke up their children to give them an antipyretic agent. Among the higher maternal education level, fear of fever was lower (odds ratio: 0.5; 95 % confidence interval: 0.28-0.91).Conclusions. One-third of survey respondents considered low body temperature values as fever. Fear of fever was high, and the level of maternal education may mitigate it.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Adulto , Conhecimentos, Atitudes e Prática em Saúde , Gerenciamento Clínico , Febre/terapia , Pais , Estudos Transversais , Inquéritos e Questionários , Antipiréticos/uso terapêutico , Febre/diagnóstico
2.
Fisioter. Pesqui. (Online) ; 27(1): 78-84, jan.-mar. 2020. tab
Artigo em Português | LILACS (Américas) | ID: biblio-1090417

RESUMO

RESUMO O objetivo deste estudo foi traduzir e adaptar a escala de utilidade clínica de Tyson e Connell para o português brasileiro, além de avaliar sua confiabilidade interexaminador e intraexaminador. O processo de tradução e adaptação transcultural foi desenvolvido em cinco estágios: tradução; síntese das traduções; retrotradução; avaliação pelo comitê de especialistas; e teste da versão pré-final. Para avaliação da confiabilidade intra e interexaminador da escala, 20 instrumentos de avaliação foram analisados de forma independente por dois examinadores (confiabilidade interexaminador). Além disso, um dos examinadores fez todas as avaliações, em dois momentos distintos, com um intervalo de 30 dias entre uma e outra (confiabilidade intraexaminador). A tradução e a adaptação transcultural foram realizadas de forma sistemática, seguindo os critérios propostos, de modo que houve apenas pequenas alterações em dois itens para tornar a escala mais útil a todos os instrumentos disponíveis na literatura. Em relação à confiabilidade interexaminador da escala de utilidade clínica de Tyson e Connell-Brasil, o valor encontrado foi CCI=0,85 (IC 95%, 0,79-0,87), enquanto para a confiabilidade intraexaminador o resultado foi CCI=0,89 (IC 95%, 0,85-0,93). Os resultados deste processo indicaram adequado grau de equivalência semântica, conceitual e cultural. Além disso, as medidas de confiabilidade intra e interexaminadores foram consideradas adequadas. Esses achados demonstraram que a escala é adequada para avaliar a utilidade clínica de instrumentos de avaliação comumente utilizados em pacientes. Dessa forma, deve ser incorporada na prática clínica e em pesquisas para a escolha do melhor instrumento.


RESUMEN O objetivo deste estudo foi traduzir e adaptar a escala de utilidade clínica de Tyson e Connell para o português brasileiro, além de avaliar sua confiabilidade interexaminador e intraexaminador. O processo de tradução e adaptação transcultural foi desenvolvido em cinco estágios: tradução; síntese das traduções; retrotradução; avaliação pelo comitê de especialistas; e teste da versão pré-final. Para avaliação da confiabilidade intra e interexaminador da escala, 20 instrumentos de avaliação foram analisados de forma independente por dois examinadores (confiabilidade interexaminador). Além disso, um dos examinadores fez todas as avaliações, em dois momentos distintos, com um intervalo de 30 dias entre uma e outra (confiabilidade intraexaminador). A tradução e a adaptação transcultural foram realizadas de forma sistemática, seguindo os critérios propostos, de modo que houve apenas pequenas alterações em dois itens para tornar a escala mais útil a todos os instrumentos disponíveis na literatura. Em relação à confiabilidade interexaminador da escala de utilidade clínica de Tyson e Connell-Brasil, o valor encontrado foi CCI=0,85 (IC 95%, 0,79-0,87), enquanto para a confiabilidade intraexaminador o resultado foi CCI=0,89 (IC 95%, 0,85-0,93). Os resultados deste processo indicaram adequado grau de equivalência semântica, conceitual e cultural. Além disso, as medidas de confiabilidade intra e interexaminadores foram consideradas adequadas. Esses achados demonstraram que a escala é adequada para avaliar a utilidade clínica de instrumentos de avaliação comumente utilizados em pacientes. Dessa forma, deve ser incorporada na prática clínica e em pesquisas para a escolha do melhor instrumento.


ABSTRACT This study aimed to translate and adapt the Clinical Utility Scale of Tyson and Connell into Brazilian Portuguese, in addition to evaluating intra- and inter-rater reliability. The process of cross-cultural translation and adaptation was developed in five stages: translation, synthesis of translations, retro translation, evaluation by the committee of experts and testing of the pre-final version. To evaluate the intra- and inter-rater reliability of the Clinical Utility Scale of Tyson and Connell, 20 assessment instruments were independently assessed by two examiners (inter-rater reliability). In addition, one of the examiners performed all assessments at two different times with a 30-day interval (intra-rater reliability). The translation and cross-cultural adaptation were performed in a systematic way, following the proposed criteria, and only minor changes in two items were necessary to make the scale more useful to all instruments currently available in the literature. Regarding the inter-rater reliability of the Clinical Utility Scale of Tyson and Connell, the value found was ICC=0.85 (IC 95%, 0,79-0,87), while for intra-rater reliability the result was ICC=0,89 (IC 95%, 0,85-0,93). The results of this process indicated an adequate degree of semantic, conceptual and cultural equivalence. In addition, intra- and inter-rater reliability measures were considered adequate. These findings have shown the scale is adequate to assess the clinical utility of evaluation instruments usually applied to patients. Therefore, it must be incorporated into clinical practice and research when choosing the best evaluation instrument to be used.


Assuntos
Tradução , Pesos e Medidas/instrumentação , Análise Custo-Benefício/métodos , Avaliação da Deficiência , Exame Físico/instrumentação , Reprodutibilidade dos Testes , Gerenciamento Clínico , Transtornos das Habilidades Motoras/diagnóstico , Limitação da Mobilidade
3.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-762182

RESUMO

PURPOSE: Data are lacking on the association between the allergic rhinitis (AR) phenotype and sensitization to specific allergens or bronchial hyperresponsiveness (BHR) in children. We here investigated risk factors and comorbidities, including sensitization to specific allergens and BHR, for the AR phenotype by AR and its Impact on Asthma (ARIA) classification in a general population-based birth cohort study. METHODS: We enrolled 606 children aged 7 years from the Panel Study of Korean Children. The AR phenotype was assigned in accordance with the ARIA classification in children. Skin prick tests and Provocholine provocation test were performed. Risk factors and comorbidities for AR phenotypes were then analyzed. RESULTS: The prevalence of mild and moderate to severe AR in our study cohort was 37.2% and 8.8%, respectively. Recent use of analgesics or antipyretics and current cat ownership were associated with the risk of mild persistent AR. Sensitizations to Dermatophagoides Pteronyssinus (Der p), Japanese hop and cat were associated with moderate to severe persistent AR. Children with moderate to severe AR had a higher risk of current asthma and BHR compared to mild AR cases (adjusted odds ratio [aOR], 5.26; 95% confidence interval [CI], 1.77–15.62). Moderate to severe AR with allergic sensitization was associated with the highest risk of BHR (aOR, 11.77; 95% CI, 3.40–40.74). CONCLUSIONS: Moderate to severe-persistent AR is more closely related to respiratory comorbidities and sensitizations than mild AR. Stratifying the AR phenotype by ARIA classification may assist in disease management.


Assuntos
Alérgenos , Analgésicos , Animais , Antipiréticos , Grupo com Ancestrais do Continente Asiático , Asma , Hiper-Reatividade Brônquica , Gatos , Criança , Classificação , Estudos de Coortes , Comorbidade , Dermatophagoides pteronyssinus , Gerenciamento Clínico , Humanos , Cloreto de Metacolina , Razão de Chances , Propriedade , Parto , Fenótipo , Prevalência , Rinite Alérgica , Fatores de Risco , Pele
4.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-785396

RESUMO

BACKGROUND: Genetic counseling (GC) provides many benefits, including the identification of patients appropriate for testing, patient education, and medical management. We evaluated the current status of and challenges faced by GC practitioners in Korean hospitals.METHODS: An electronic survey was designed and conducted in 52 certified laboratory physicians belonging to the Korean Society of Laboratory Medicine, from August to September 2018. The questionnaires addressed three main categories of information: (1) current status of GC in hospitals; (2) essential qualifications of GC practitioners; and (3) challenges and perspectives for GC. Fisher's exact test was applied to analyze categorical data.RESULTS: Among a total of 52 participants who initially responded, 12 (23.1%) were performing GC either by direct or indirect care. GC clinics were opened regularly for one (33.3%) or more than three sessions (25.0%) per week; most respondents spent more time for pre-visit activities than in-person visits, both for a initial visit patient and for a follow-up visit patient. All laboratory physicians provided genetic information to their patients. Most recommended family genetic testing when indicated (91.7%), discussed disease management (75.0%), and/or ordered additional genetic testing (58.3%), and some referred patients to other specialists (8.3%).CONCLUSIONS: Both patients and laboratory physicians concede the advantage of GC performed by clinical geneticists; however, the practice of GC involves several challenges and raises some concerns. The cost and support required to implement GC need to be addressed in order to provide qualified GC in Korea.


Assuntos
Gerenciamento Clínico , Seguimentos , Aconselhamento Genético , Testes Genéticos , Humanos , Coreia (Geográfico) , Educação de Pacientes como Assunto , Especialização , Inquéritos e Questionários
5.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-782239

RESUMO

PURPOSE: We sought to compare the efficacy as well as the safety of two maximum medical therapy combinations applied to lower the intraocular pressure (IOP) in different primary open-angle glaucoma (POAG) age groups.METHODS: This was a retrospective, consecutive case series study that included 60 eyes of 60 subjects with POAG, specifically 20 subjects aged 40 to 54 years, 21 aged 55 to 69 years, and 19 aged 70 years or older. All had been treated for at least 12 months with triple maximum medical therapy (TMT; dorzolamide/timolol, brimonidine, and latanoprost) to lower their IOP, which subsequently was changed to double maximum medical therapy (DMT, fixed drug combinations of tafluprost/timolol and brinzolamide/brimonidine). The rate of IOP change and adverse drug reactions were compared amongst the three age groups.RESULTS: The mean IOP change at three months after converting from TMT to DMT was −0.65 ± 1.42 mmHg (−3.84% ± 9.31%) among the overall study group, but this finding was not statistically significant (p = 0.108). In the 40 to 54 years and 55 to 69 years groups, the mean IOP change rates were +0.29 ± 0.96 mmHg (+2.40% ± 6.85%, p = 0.087) and −0.50 ± 0.99 mmHg (−3.05% ± 6.40%, p = 0.084) respectively. In the 70 years or older group, the mean IOP change, interestingly, was −1.80 ± 1.46 mmHg (−11.29% ± 9.31%, p < 0.001) and nine (47.4%) of the 19 subjects showed additional IOP reductions of 10% or more after converting from TMT to DMT. In all three age groups, the incidence rate of dry eye was significantly lower for DMT than for TMT (p = 0.031).CONCLUSIONS: In POAG patients, DMT was proven to be both effective and safe for lowering the IOP, especially in those 70 years or older group, when compared with the TMT protocol.


Assuntos
Tartarato de Brimonidina , Gerenciamento Clínico , Combinação de Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos , Glaucoma de Ângulo Aberto , Humanos , Incidência , Pressão Intraocular , Estudos Retrospectivos
6.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-782224

RESUMO

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


Assuntos
Asma , Bronquite , Estudos de Coortes , Tosse , Diagnóstico , Gerenciamento Clínico , Eosinófilos , Epidemiologia , Feminino , Refluxo Gastroesofágico , Humanos , Coreia (Geográfico) , Pneumopatias , Análise Multivariada , Estudo Observacional , Gestantes , Estudos Retrospectivos , Tuberculose
8.
Rev. medica electron ; 41(4): 940-958, jul.-ago. 2019.
Artigo em Espanhol | LILACS (Américas), CUMED | ID: biblio-1094100

RESUMO

RESUMEN El síndrome de ovario poliquístico se ha convertido en un problema de salud pública, siendo el más común de los desórdenes endocrinos en mujeres en edad reproductiva con estudios que reportan una prevalencia de hasta un 21%. El diagnóstico de esta entidad es importante debido a que representa riesgos metabólicos, cardiovasculares y afecta la capacidad reproductiva de estas pacientes. Se realizó una revisión bibliográfica de los principales artículos relacionados sobre el tema, resumiendo los aspectos fundamentales de este problema de salud.


ABSTRACT Polycystic ovary syndrome has become a public health problem, being the most common of the endocrine disorders in reproductive-age women, with studies reporting prevalence by 21 %. The diagnosis of this entity is important because it represents metabolic and cardiovascular risk, and affects the reproductive capacity of these patients. The authors carried out bibliographic review of the main articles related with the theme, summarizing the basic aspects of this health problem.


Assuntos
Humanos , Feminino , Síndrome do Ovário Policístico/complicações , Síndrome do Ovário Policístico/etiologia , Síndrome do Ovário Policístico/fisiopatologia , Síndrome do Ovário Policístico/diagnóstico por imagem , Serviços Preventivos de Saúde , Doenças Cardiovasculares/diagnóstico , Gerenciamento Clínico , Síndrome Metabólica/diagnóstico , Doenças do Sistema Endócrino/diagnóstico , Prevenção de Doenças , Saúde Reprodutiva , Estilo de Vida Saudável , Genitália/fisiopatologia , Resistência à Insulina , Ultrassonografia , Hirsutismo/diagnóstico , Hipertensão/diagnóstico , Distúrbios Menstruais/diagnóstico , Obesidade/diagnóstico
9.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 41(4): 324-335, July-Aug. 2019. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1011506

RESUMO

Objective: To present the essential guidelines for pharmacological management of patients with psychomotor agitation in Brazil. Methods: This is a systematic review of articles retrieved from the MEDLINE (PubMed), Cochrane Database of Systematic Reviews, and SciELO databases published from 1997 to 2017. Other relevant articles in the literature were also used to develop these guidelines. The search strategy used structured questions formulated using the PICO model, as recommended by the Guidelines Project of the Brazilian Medical Association. Recommendations were summarized according to their level of evidence, which was determined using the Oxford Centre for Evidence-based Medicine system and critical appraisal tools. Results: Of 5,362 articles retrieved, 1,731 abstracts were selected for further reading. The final sample included 74 articles that met all inclusion criteria. The evidence shows that pharmacologic treatment is indicated only after non-pharmacologic approaches have failed. The cause of the agitation, side effects of the medications, and contraindications must guide the medication choice. The oral route should be preferred for drug administration; IV administration must be avoided. All subjects must be monitored before and after medication administration. Conclusion: If non-pharmacological strategies fail, medications are needed to control agitation and violent behavior. Once medicated, the patient should be monitored until a tranquil state is possible without excessive sedation. Systematic review registry number: CRD42017054440.


Assuntos
Humanos , Agitação Psicomotora/tratamento farmacológico , Antipsicóticos/administração & dosagem , Benzodiazepinas/administração & dosagem , Guias de Prática Clínica como Assunto , Escalas de Graduação Psiquiátrica , Agitação Psicomotora/diagnóstico , Antipsicóticos/classificação , Benzodiazepinas/classificação , Brasil , Gerenciamento Clínico
11.
Rev. bras. psiquiatr ; 41(2): 153-167, Mar.-Apr. 2019. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-990823

RESUMO

Objective: To present the essential guidelines for non-pharmacological management of patients with psychomotor agitation in Brazil. Methods: These guidelines were developed based on a systematic review of articles published from 1997 to 2017, retrieved from MEDLINE (PubMed), Cochrane Database of Systematic Review, and SciELO. Other relevant articles identified by searching the reference lists of included studies were also used to develop these guidelines. The search strategy used structured questions formulated using the PICO model, as recommended by the Guidelines Project of the Brazilian Medical Association. Recommendations were summarized according to their level of evidence, which was determined using the Oxford Centre for Evidence-based Medicine system and critical appraisal tools. Results: We initially selected 1,731 abstracts among 5,362 articles. The final sample included 104 articles that fulfilled all the inclusion criteria. The management of agitated patients should always start with the least coercive approach. The initial non-pharmacological measures include a verbal strategy and referral of the patient to the appropriate setting, preferably a facility designed for the care of psychiatric patients with controlled noise, lighting, and safety aspects. Verbal de-escalation techniques have been shown to decrease agitation and reduce the potential for associated violence in the emergency setting. The possibility of underlying medical etiologies must be considered first and foremost. Particular attention should be paid to the patient's appearance and behavior, physical signs, and mental state. If agitation is severe, rapid tranquilization with medications is recommended. Finally, if verbal measures fail to contain the patient, physical restraint should be performed as the ultimate measure for patient protection, and always be accompanied by rapid tranquilization. Healthcare teams must be thoroughly trained to use these techniques and overcome difficulties if the verbal approach fails. It is important that healthcare professionals be trained in non-pharmacological management of patients with psychomotor agitation as part of the requirements for a degree and graduate degree. Conclusion: The non-pharmacological management of agitated patients should follow the hierarchy of less invasive to more invasive and coercive measures, starting with referral of the patient to an appropriate environment, management by a trained team, use of verbal techniques, performance of physical and mental assessment, use of medications, and, if unavoidable, use of the mechanical restraint. Systematic review registry number: CRD42017054440.


Assuntos
Humanos , Agitação Psicomotora/diagnóstico , Agitação Psicomotora/terapia , Guias de Prática Clínica como Assunto , Gerenciamento Clínico , Escalas de Graduação Psiquiátrica , Brasil
12.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-763676

RESUMO

BACKGROUND: The study aimed to evaluate the effects of dapagliflozin and metformin on vascular endothelial function and renal injury markers. METHODS: This prospective, randomized, open-label, crossover study included drug-naïve patients with type 2 diabetes mellitus, who were randomized to receive 8 weeks of initial treatment using metformin or dapagliflozin and crossed over for another 8 weeks of treatment after a 1-week washout period. Systemic endothelial function was evaluated via the reactive hyperemic index (RHI). RESULTS: The 22 participants included 10 males (45.5%) and had a median age of 58 years. The RHI values were not significantly changed during both 8-week treatment periods and there was no significant difference between the treatments. Relative to the metformin group, 8 weeks of dapagliflozin treatment produced significantly higher median N-acetyl-beta-D-glucosaminidase levels (10.0 ng/mL [interquartile range (IQR), 6.8 to 12.1 ng/mL] vs. 5.6 ng/mL [IQR, 3.8 to 8.0 ng/mL], P=0.013). Only the dapagliflozin group exhibited improved homeostatic model assessment of insulin resistance and body weight, while serum ketone and β-hydroxybutyrate levels increased. CONCLUSION: Dapagliflozin treatment did not affect systemic endothelial function or renal injury markers except N-acetyl-beta-D-glucosaminidase.


Assuntos
Acetilglucosaminidase , Peso Corporal , Estudos Cross-Over , Diabetes Mellitus , Diabetes Mellitus Tipo 2 , Gerenciamento Clínico , Humanos , Resistência à Insulina , Masculino , Metformina , Estudos Prospectivos
13.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-740714

RESUMO

OBJECTIVES: In the Republic of Korea (ROK), the notified incidence of tuberculosis in foreign-born individuals (NITFBI) has increased recently, as has the rate of multidrug-resistant (MDR) and rifampicin-resistant (RR) tuberculosis in foreigners staying in the ROK. As Jeju Province in ROK has a no-visa entry policy, control programs for NITFBI should be consolidated. The aim was to evaluate the status of NITFBI, with a focus on the distribution of MDR/RR tuberculosis by nationality. METHODS: Data on tuberculosis incidence in individuals born in Jeju Province and in foreign-born individuals were extracted from the Korean Statistical Information Service of Statistics Korea, and the Infectious Disease Surveillance Web Statistics of the Korea Centers for Disease Control and Prevention, respectively. RESULTS: Among all notified incident cases of tuberculosis, the proportion of NITFBI increased from 1.46% in 2011 to 6.84% in 2017. China- and Vietnam-born individuals accounted for the greatest proportion of the 95 cases of NITFBI. Seven cases of MDR/RR tuberculosis were found, all involving patients born in China. CONCLUSIONS: In Jeju Province, ROK, NITFBI might become more common in the near future. Countermeasures for controlling active tuberculosis in immigrants born in high-risk nations for tuberculosis should be prepared in Jeju Province, since it is a popular tourist destination.


Assuntos
Antituberculosos , China , Doenças Transmissíveis , Gerenciamento Clínico , Resistência a Medicamentos , Emigrantes e Imigrantes , Grupos Étnicos , Humanos , Incidência , Serviços de Informação , Internacionalidade , Coreia (Geográfico) , Mycobacterium tuberculosis , República da Coreia , Tuberculose
14.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-786525

RESUMO

Hyperleukocytosis (HL), defined by a peripheral white blood cell (WBC) count exceeding 100,000/mm³, is occasionally observed in childhood acute leukemia. The increased viscosity in the micro-circulation by HL and the interaction between the leukemic blasts and endometrium of blood vessels sometimes result in leukostasis. Leukostasis can incur life-threatening manifestations, such as respiratory distress, brain infarction and hemorrhage, and renal failure, needing an emergency care. Although early stage of leukostasis is difficult to detect due to nonspecific manifestations, an emergency care is mandatory because leukostasis can proceed to a fatal course. Initial management includes an aggressive fluid therapy that can reduce WBC count, and prevent other metabolic complications implicated by HL. Packed red blood cells should be judiciously transfused because it increases blood viscosity. Conversely, transfusion of platelet concentrates or fresh frozen plasma, which does not affect blood viscosity, is recommended for prevention of hemorrhage. To reduce tumor burden, leukapheresis or exchange transfusion is commonly performed. However, the efficacy is still controversial, and technical problems are present. Leukapheresis or exchange transfusion is recommended if WBC count is 200,000–300,000/mm³ or more, especially in acute myelocytic leukemia, or manifestations of leukostasis are present. In addition, early chemotherapy is the definite treatment of leukostasis.


Assuntos
Plaquetas , Vasos Sanguíneos , Viscosidade Sanguínea , Infarto Encefálico , Gerenciamento Clínico , Tratamento Farmacológico , Emergências , Serviços Médicos de Emergência , Serviço Hospitalar de Emergência , Endométrio , Eritrócitos , Feminino , Hidratação , Hemorragia , Leucaférese , Leucemia , Leucemia Mieloide Aguda , Transtornos Leucocíticos , Leucócitos , Leucocitose , Leucostasia , Plasma , Insuficiência Renal , Carga Tumoral , Viscosidade
15.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-786464

RESUMO

The term theranostics is a combination of a diagnostic tool that helps to define a right therapeutic tool for specific disease and paves the approach towards personalized or precision medicine. In Nuclear Medicine, a diagnostic radionuclide is labeled with the target and once expression is documented, the same target is labeled with a therapeutic radionuclide and treatment is executed. The theranostic concept was applied first time in 1964 in the treatment of thyroid cancer with I-131 (RAI). Over the years, other theranostic radiotracers became available indigenously from the Bhabha Atomic Research Centre (BARC) in the country. Currently Lu-177 is produced in India and peptides like DOTATATE and PSMA are available in a kit form indigenously. At the present time, the radionuclide therapies of oncological disorders which are being performed in India are mainly for neuroendocrine tumors (NET) and metastatic castration resistant prostate cancer (mCRPC). The main constraints pertaining to this concept is the cost of treatment and awareness among the clinicians which are gradually being taken care of by the private health insurance and our participation in disease management group meetings respectively. The theranostic concept has become popular over the years and has the potential for sustained growth.


Assuntos
Castração , Gerenciamento Clínico , Processos Grupais , Humanos , Índia , Seguro Saúde , Tumores Neuroendócrinos , Medicina Nuclear , Peptídeos , Medicina de Precisão , Neoplasias da Próstata , Nanomedicina Teranóstica , Neoplasias da Glândula Tireoide
16.
Artigo em Chinês | WPRIM (Pacífico Ocidental) | ID: wprim-775242

RESUMO

Drug therapy plays an important role in alleviating the symptoms related to adenomyosis, improving the curative effect of surgery, delaying the progress of disease and promoting assisted reproduction. Non-steroidal anti-inflammatory drugs (NSAIDs) are the first choice to control pain associated with adenomyosis, and are the only choice for patients with recent fertility requirements; steroid hormones, gonadotropin releasing hormone agonists and mifepristone can effectively relieve pain and control uterine bleeding, among which oral contraceptives, levonorgestrel-releasing intranterine system (Mirena) and dienogest are more effective and commonly used in clinic. Drug selection should be based on patient's age, symptoms, uterine size, fertility requirements and economical conditions. At present, there is no specific drug for adenomyosis, and symptoms are easy to recur after drug withdrawal, so the long-term drug use needs further study.


Assuntos
Adenomiose , Tratamento Farmacológico , Gerenciamento Clínico , Feminino , Humanos , Recidiva
17.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-761289

RESUMO

OBJECTIVES: Over the last decades, numerous studies on the effect of vestibular rehabilitation (VR) have been reported in western countries, but there has been no report about real experiences of customized VR in Korea. The aim of this study was to analyze of the efficacy, compliance and satisfaction in patients with acute and chronic dizziness. METHODS: Patients with dizziness were treated with a customized VR at least 4 weeks. Subjects were assessed before and after at least 4 weeks of customized VR for visual analogue scale (VAS) and disability scale (DS). Patients were asked to score the satisfaction of their treatment as 1 (very poor) to 5 (excellent). Compliance to exercise program were graded as 1 (regularly performed), 2 (frequently performed), or 3 (rarely performed). RESULTS: Thirty-two patients with dizziness were included. Diagnosis of patients were vestibular migraine (n=5), Meniere's disease (n=2), vestibular neuritis (n=10), persistent perceptual positional dizziness (n=10), bilateral vestibulopathy (n=3), and central dizziness (n=2). Mean VAS and DS before VR were 15.3 and 2.4, respectively. Mean VAS and DS after VR were 4.5 and 0.7, respectively. Significant improvements in VAS and DS were observed after VR (p=0.00). Mean treatment satisfaction score was 3.3±1.0 and mean compliance score was 2.3±0.8. Satisfaction to VR showed positive correlation with patient's compliance. (p=0.00, r=0.644) CONCLUSIONS: Significant improvements were seen in symptom and disability in patients with acute and chronic dizziness after customized VR. Patients showed moderate compliance to exercise program and overall satisfaction was fair.


Assuntos
Complacência (Medida de Distensibilidade) , Diagnóstico , Gerenciamento Clínico , Tontura , Humanos , Coreia (Geográfico) , Doença de Meniere , Transtornos de Enxaqueca , Reabilitação , Doenças Vestibulares , Neuronite Vestibular
18.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-760874

RESUMO

PURPOSE: No national survey has yet described the guidelines followed by Korean pediatricians to treat acute gastroenteritis (AGE). An online survey was performed to investigate the management of AGE followed by members of The Korean Society of Pediatric Gastroenterology, Hepatology, and Nutrition, and the results were compared between pediatric gastroenterologists (PG) and general pediatricians (GP). METHODS: Questionnaires were sent to pediatricians between June 2 and 4, 2018 regarding the type of hospital, indications for admission, antiemetic and antidiarrheal drugs and antibiotics prescribed, and dietary changes advised. RESULTS: Among the 400 pediatricians approached, 141 pediatricians (35.3%) responded to the survey. PG comprised 39% of the respondents and 72.7% worked at a tertiary hospital. Both PG and GP considered diarrhea or vomiting to be the primary symptom. The most common indication for hospitalization was severe dehydration (98.8%). Most pediatricians managed dehydration with intravenous fluid infusions (PG 98.2%, GP 92.9%). Antiemetics were prescribed by 87.3% of PG and 96.6% of GP. Probiotics to manage diarrhea were prescribed by 89.1% of PG and 100.0% of GP. Antibiotics were used in children with blood in diarrheal stool or high fever. Dietary changes were more commonly recommended by GP (59.3%) than by PG (27.3%) (p<0.05). Tests to identify etiological agents were performed primarily in hospitalized children. CONCLUSION: This survey assessing the management of pediatric AGE showed that the indications for admission and rehydration were similar between GP and PG. Drug prescriptions for diarrhea and dietary changes were slightly commonly recommended by GP than by PG.


Assuntos
Antibacterianos , Antidiarreicos , Antieméticos , Criança , Criança Hospitalizada , Desidratação , Diarreia , Gerenciamento Clínico , Prescrições de Medicamentos , Febre , Hidratação , Gastroenterite , Gastroenterologia , Hospitalização , Humanos , Probióticos , Inquéritos e Questionários , Centros de Atenção Terciária , Vômito
19.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-760637

RESUMO

BACKGROUND/OBJECTIVES: This study evaluated whether a mobile health (mHealth) application can instigate healthy behavioral changes and improvements in metabolic disorders in individuals with metabolic abnormalities. SUBJECTS/METHODS: Participants were divided into an mHealth intervention group (IG), which used a mobile app for 24 weeks, and a conventional IG. All mobile apps featured activity monitors, with blood pressure and glucose monitors, and body-composition measuring devices. The two groups were compared after 24 weeks in terms of health-behavior practice rate and changes in the proportion of people with health risks, and health behaviors performed by the IG that contributed to reductions in more than one health risk factor were analyzed using multiple logistic regression. RESULTS: Preference for low-sodium diet, reading nutritional facts, having breakfast, and performing moderate physical activity significantly increased in the mHealth IG. Furthermore, the mHealth IG showed a significant increase of eight items in the mini-dietary assessment; particularly, the items “I eat at least two types of vegetables of various colors at every meal” and “I consume dairies, such as milk, yogurt, and cheese, every day.” The proportion of people with health risks, with the exception of fasting glucose, significantly decreased in the mHealth IG, while only the proportion of people with at-risk triglycerides and waist circumference of females significantly decreased in the control group. Finally, compared to those who did not show improvements of health risks, those who showed improvements of health risks in the mHealth IG had an odds ratio of 1.61 for moderate to vigorous physical activity, 1.65 for “I do not add more salt or soy sauce in my food,” and 1.77 for “I remove fat in my meat before eating.” CONCLUSIONS: The findings suggest that the additional use of a community-based mHealth service through a mobile application is effective for improving health behaviors and lowering metabolic risks in Koreans.


Assuntos
Pressão Sanguínea , Desjejum , Queijo , Assistência à Saúde , Dieta , Dieta Hipossódica , Gerenciamento Clínico , Jejum , Feminino , Glucose , Comportamentos Relacionados com a Saúde , Humanos , Modelos Logísticos , Carne , Leite , Aplicativos Móveis , Atividade Motora , Razão de Chances , Saúde Pública , Fatores de Risco , Smartphone , Alimentos de Soja , Telemedicina , Triglicerídeos , Verduras , Circunferência da Cintura , Iogurte
20.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-719416

RESUMO

PTEN hamartoma tumor syndrome is a spectrum of disorders characterized by unique phenotypic features including multiple hamartomas caused by mutations of the tumor suppressor gene PTEN. Cowden syndrome and Bannayan–Riley–Ruvalcaba syndrome are representative diseases, and both have several common clinical features and differences. Because PTEN mutations are associated with an increased risk of malignancy including breast, thyroid, endometrial, and renal cancers, cancer surveillance is an important element of disease management. We report a germline mutation of the PTEN (c.723dupT, exon 7) identified in a young woman with a simultaneous occurrence of breast cancer, dermatofibrosarcoma protuberans, and follicular neoplasm. This case suggests that it is critical for clinicians to recognize the phenotypic features associated with these syndromes to accurately diagnose them and provide preventive care.


Assuntos
Mama , Neoplasias da Mama , Dermatofibrossarcoma , Gerenciamento Clínico , Éxons , Feminino , Genes Supressores de Tumor , Mutação em Linhagem Germinativa , Hamartoma , Síndrome do Hamartoma Múltiplo , Humanos , Neoplasias Renais , Glândula Tireoide
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