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1.
Rev. salud pública ; 22(3): e184617, May-June 2020. tab, graf
Artigo em Espanhol | LILACS (Américas) | ID: biblio-1115881

RESUMO

RESUMEN Latinoamérica, al igual que el resto del mundo, se está enfrentando actualmente a las consecuencias del envejecimiento poblacional, entre las que se incluye el aumento en la incidencia de neoplasias malignas en adultos mayores, con un subsecuente incremento en la uso de servicios de salud oncológicos. La oncología geriátrica es una disciplina de reciente creación que suma principios geriátricos a los avances oncológicos para ofrecer un tratamiento individualizado a los adultos mayores con cáncer. Este abordaje multidisciplinario actualmente es recomendado en el cuidado oncológico rutinario en adultos mayores. En Latinoamérica existen varias iniciativas asistenciales de enseñanza e investigación en oncología geriátrica; sin embargo, el número de centros especializados y la disponibilidad de personal capacitado en el área es limitada en comparación con los recursos disponibles en países de ingresos altos. En este trabajo se describen recomendaciones internacionales para la implementación de los principios de la oncología geriátrica en la práctica clínica habitual, los centros y recursos con los que se cuenta en Latinoamérica y los retos a futuro para mejorar la atención multidisciplinaria de los adultos mayores con cáncer en la región.(AU)


ABSTRACT Latin America, like the rest of the world, is currently facing the consequences of population aging. Among these consequences is a rise in incidence in malignant neoplasms among older adults, with an anticipated increase in oncologic health service requirements in this population. Geriatric oncology is a recently created discipline which integrates geriatric principles into oncology care to offer older adults with cancer individualized treatments. This multidisciplinary approach is now recommended as part of routine oncology care by international associations. Although several geriatric oncology clinical, educational and research initiatives exist in Latin America, the number and availability of specialized facilities and personnel is limited in comparison to those in high-income regions. In this manuscript, we review international recommendations for the implementation of geriatric oncology principles into routine clinical practice, describe resources available for geriatric oncology in Latin America, and provide recommendations to improve multidisciplinary care for older adults with cancer in the region.(AU)


Assuntos
Humanos , Pessoa de Meia-Idade , Idoso , Institutos de Câncer/organização & administração , Envelhecimento , Serviços de Saúde para Idosos/organização & administração , Neoplasias/epidemiologia , Incidência , América Latina/epidemiologia
2.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 31-37, Jan.-Mar. 2020. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1090554

RESUMO

Abstract Introduction Diseases of the salivary glands are rare in children and adolescents, with the exception of viral-induced infections. Objective To determine the clinical course of the disease, the diagnostic procedures, the treatment and the outcome of all children and adolescents affected with salivary gland diseases at our clinic over a period of 15 years. Methods A retrospective chart review including a long-term follow-up was conducted among 146 children and adolescents treated for salivary gland disorders from 2002 to 2016. Results Diagnosing acute sialadenitis was easily managed by all doctors regardless of their specialty. The diagnosis of sialolithiasis was rapidly made only by otorhinolar- yngologists, whereas diagnosing juvenile recurrent parotitis imposed difficulties to doctors of all specialties - resulting in a significant delay between the first occurrence of symptoms and the correct diagnosis. The severity-adjusted treatment yielded improve- ments in all cases, and a full recovery of 75% of the cases of sialolithiasis, 73% of the cases of juvenile recurrent parotitis, and 100% of the cases of acute sialadenitis. Conclusions Due to their low prevalence and the lack of pathognomonic symptoms, salivary gland diseases in children and adolescents are often misdiagnosed, resulting in an unneces- sarily long period of suffering despite a favorable outcome following the correct treatment.


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Criança , Adolescente , Doenças das Glândulas Salivares/diagnóstico , Doenças das Glândulas Salivares/patologia , Doenças das Glândulas Salivares/terapia , Doenças das Glândulas Salivares/epidemiologia , Parotidite/epidemiologia , Sialadenite/epidemiologia , Espectroscopia de Ressonância Magnética , Cálculos das Glândulas Salivares/epidemiologia , Tomografia Computadorizada por Raios X , Registros Médicos , Incidência , Prevalência , Estudos Retrospectivos , Estudos Longitudinais , Ultrassonografia , Biópsia por Agulha Fina , Alemanha
3.
Int. arch. otorhinolaryngol. (Impr.) ; 24(1): 5-10, Jan.-Mar. 2020. tab
Artigo em Inglês | LILACS (Américas) | ID: biblio-1090555

RESUMO

Abstract Introduction The cochlea and the vestibular receptors are closely related in terms of anatomy and phylogeny. Patients with moderate to profound sensorineural hearing loss (MPSHL) should have their vestibular organ functions tested. Objective To evaluate the incidence of vestibular abnormalities in patients with MPSHL and to study the correlation between the etiology of hearing loss (HL) and a possible damage to the labyrinth. Methods A case-control retrospective study was performed. In the case group, 20 adults with MPSHL of known etiology were included. The control group was composed of 15 adults with normal hearing. The case group was divided into 4 subgroups based on the etiology (bacterial meningitis, virus, vascular disease, congenital). Cervical vestibular-evoked myogenic potentials (cVEMPs) were used to rate the saccular function and lower vestibular nerve. Results The study was performed in 70 ears, and it highlighted the presence of early biphasic P1-N1 complex in 29 (71.5%) out of 40 ears in the study group, and in all of the 30 ears in the control group (p = 0.001). Regarding the presence or absence of cVEMPs among the four subgroups of patients with MPSHL, the data were statistically significant (p < 0.001). The comparison between the latencies and amplitude of P1-N1 in case and control groups from other studies and in the four subgroups of cases in the present study did not detect statistically significant differences. Conclusion The present study demonstrates that patients with MPSHL have a high incidence of damage to the labyrinthine organs, and it increases the current knowledge about the etiopathogenesis of sensorineural HL, which is often of unknown nature.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Potenciais Evocados Miogênicos Vestibulares , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/fisiopatologia , Audiometria de Tons Puros , Doenças Vasculares/complicações , Viroses/complicações , Estudos de Casos e Controles , Doenças Vestibulares/diagnóstico , Doenças Vestibulares/epidemiologia , Incidência , Estudos Retrospectivos , Meningites Bacterianas/complicações , Perda Auditiva Neurossensorial/congênito , Doenças do Labirinto/diagnóstico , Doenças do Labirinto/fisiopatologia , Doenças do Labirinto/epidemiologia
4.
Braz. J. Psychiatry (São Paulo, 1999, Impr.) ; 42(1): 72-76, Jan.-Feb. 2020. tab, graf
Artigo em Inglês | LILACS (Américas) | ID: biblio-1055367

RESUMO

Objective: Depression has been associated with hepatitis C, as well as with its treatment with proinflammatory cytokines (i.e., interferon). The new direct-acting antiviral agents (DAAs) have minimal adverse effects and high potency, with a direct inhibitory effect on non-structural viral proteins. We studied the incidence and associated factors of depression in a real-life prospective cohort of chronic hepatitis C patients treated with the new DAAs. Methods: The sample was recruited from a cohort of 91 patients with hepatitis C, of both sexes, with advanced level of fibrosis and no HIV coinfection, consecutively enrolled during a 6-month period for DAA treatment; those euthymic at baseline (n=54) were selected. All were evaluated through the depression module of the Patient Health Questionnaire (PHQ-9-DSM-IV), at three time points: baseline, 4 weeks, and end-of-treatment. Results: The cumulative incidence (95%CI) of major depression and any depressive disorder during DAA treatment was 13% (6.4-24.4) and 46.3% (33.7-59.4), respectively. No differences were observed between those patients with and without cirrhosis or ribavirin treatment (p > 0.05). Risk factors for incident major depression during DAA treatment included family depression (relative risk 9.1 [1.62-51.1]), substance use disorder (11.0 [1.7-73.5]), and baseline PHQ-9 score (2.1 [1.1-3.1]). Conclusions: The findings of this study highlight the importance of screening for new depression among patients receiving new DAAs, and identify potential associated risk factors.


Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Antivirais/uso terapêutico , Hepatite C/psicologia , Hepatite C/tratamento farmacológico , Transtorno Depressivo/epidemiologia , Escalas de Graduação Psiquiátrica , Ribavirina/uso terapêutico , Espanha/epidemiologia , Fatores de Tempo , Modelos Logísticos , Incidência , Estudos Prospectivos , Fatores de Risco , Resultado do Tratamento , Hepatite C/epidemiologia , Pessoa de Meia-Idade
5.
Artigo em Português | LILACS (Américas) | ID: biblio-1097199

RESUMO

Objetivos: prever a tendência epidemiológica de casos e óbitos do COVID-19 no Brasil e, especificamente, em Mato Grosso, por meio do modelo estatístico duplo exponencial. Métodos: para a realização deste trabalho, foram utilizados dados de casos e óbitos do COVID-19 fornecidos pelo Ministério da Saúde do Brasil e Secretaria de Estado de Saúde de Mato Grosso, e, para realizar as previsões com esses dados, foi utilizada a técnica estatística de séries temporais, considerando o modelo exponencial duplo, e para o processamento dos dados, foi utilizado o programa MINITAB V 17. Resultados: os resultados mostram que os valores ajustados pelo modelo exponencial duplo transformado dos casos e óbitos estão muito próximos dos valores observados de COVID-19 no Brasil e, principalmente, em Mato Grosso, no período considerado, indicando que esse modelo é adequado para os dados em estudo, o qual foi verificado, prevendo alguns valores com seus respectivos intervalos de confiança de 95%. Conclusões: a possibilidade de se estimar, pautado em análises estatísticas, o número de casos e óbitos de COVID-19 que ocorrerá no Brasil e no estado de Mato Grosso poderá instrumentalizar os gestores para o planejamento de ações estratégicas de prevenção, monitoramento e controle da pandemia.(AU)


Objective: to predict the epidemiological trend of COVID-19 cases and deaths in Brazil and Mato Grosso state using the double exponential statistical model. Methods: in order to carry out this work, data on cases and deaths from COVID-19 provided by the Ministry of Health of Brazil and the State Secretariat of Health of Mato Grosso were used and to make the predictions with these data, the time series statistical technique was used, considering the double exponential model and the MINITAB V 17 program was used for data processing. Results: the results show that the values adjusted by the double exponential transformed model of cases and deaths are very close to the observed values of COVID-19 in Brazil and Mato Grosso, in the period considered, indicating that this model is suitable for the data under study, which was verified by predicting some values with their respective 95% confidence intervals. Conclusions: the possibility of estimating, based on statistical analysis, the number of cases and deaths of COVID-19 that will occur in Brazil and in the state of Mato Grosso, may instrumentalize the managers for the planning of strategic actions for prevention, monitoring and control of pandemic.(AU)


Assuntos
Humanos , Atestado de Óbito , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/epidemiologia , Brasil , Estudos de Séries Temporais , Incidência
6.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-762473

RESUMO

BACKGROUND: Although the incidence of tuberculosis (TB) is decreasing, cases of multidrug-resistant (MDR) TB and extensively drug-resistant (XDR) TB continue to increase. As conventional phenotype drug susceptibility testing (pDST) takes six to eight weeks, molecular assays are widely used to determine drug resistance. we developed QuantaMatrix Multiplexed Assay Platform (QMAP) MDR/XDR assay (QuantaMatrix Inc., Seoul, Korea) that can simultaneously detect mutations related to both first- and second-line drug resistance (rifampin, isoniazid, ethambutol, fluoroquinolones, second-line injectable drugs, and streptomycin). METHODS: We used 190 clinical Mycobacterium tuberculosis (MTB) strains isolated from Myanmar, compared QMAP and pDST results, and determined concordance rates. Additionally, we performed sequence analyses for discordant results. RESULTS: QMAP results were 87.9% (167/190) concordant with pDST results. In the 23 isolates with discordant results, the QMAP and DNA sequencing results completely matched. CONCLUSIONS: The QMAP MDR/XDR assay can detect all known DNA mutations associated with drug resistance for both MDR- and XDR-MTB strains. It can be used for molecular diagnosis of MDR- and XDR-TB to rapidly initiate appropriate anti-TB drug therapy.


Assuntos
Diagnóstico , DNA , Resistência a Medicamentos , Tratamento Farmacológico , Etambutol , Tuberculose Extensivamente Resistente a Medicamentos , Fluoroquinolonas , Incidência , Isoniazida , Mianmar , Mycobacterium tuberculosis , Fenótipo , Seul , Análise de Sequência , Análise de Sequência de DNA , Tuberculose , Tuberculose Resistente a Múltiplos Medicamentos
7.
Korean Circulation Journal ; : 112-119, 2020.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-786228

RESUMO

Kawasaki disease is a form of vasculitis, mainly in small and medium arteries of unknown origin, occurring frequently in childhood. It is the leading form of childhood-onset acquired heart disease in developed countries and leads to complications of coronary artery aneurysms in approximately 25% of cases if left untreated. Although more than half a century has passed since Professor Tomisaku Kawasaki's first report in 1957, the cause is not yet clear. Currently, intravenous immunoglobulin therapy has been established as the standard treatment for Kawasaki disease. Various treatment strategies are still being studied under the slogan, “Ending powerful inflammation in the acute phase as early as possible and minimizing the incidence of coronary artery lesions,” as the goal of acute phase treatments for Kawasaki disease. Currently, in addition to immunoglobulin therapy, steroid therapy, therapy using infliximab, biological products, suppression of elastase secretion inside and outside the neutrophils, inactivated ulinastatin therapy and cyclosporine therapy, plasma exchange, etc. are performed. This chapter outlines the history and transition of the acute phase treatment for Kawasaki disease.


Assuntos
Aneurisma , Artérias , Produtos Biológicos , Vasos Coronários , Ciclosporina , Países Desenvolvidos , Cardiopatias , Imunização Passiva , Incidência , Inflamação , Infliximab , Síndrome de Linfonodos Mucocutâneos , Neutrófilos , Elastase Pancreática , Troca Plasmática , Prednisolona , Vasculite
8.
Korean Circulation Journal ; : 120-129, 2020.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-786227

RESUMO

BACKGROUND AND OBJECTIVES: There is a paucity of data regarding the benefit of clopidogrel monotherapy after dual antiplatelet therapy (DAPT) in patients treated with drug-eluting stents (DES). This study compared outcome between clopidogrel versus aspirin as monotherapy after DES for acute myocardial infarction (MI).METHODS: From Korea Acute Myocardial Infarction Registry-National Institute of Health database, 1,819 patients treated with DES who were switched to monotherapy with clopidogrel (n=534) or aspirin (n=1,285) after uneventful 12-month DAPT were analyzed. The primary endpoint was net adverse clinical events (NACE), defined as a composite of death from any cause, MI, repeat percutaneous coronary intervention (PCI), stent thrombosis, ischemic stroke, or major bleeding during the period from 12 to 24 months.RESULTS: After adjustment using inverse probability of treatment weighting, patients who received clopidogrel, compared with those treated with aspirin, had a similar incidence of NACE (0.7% and 0.7%; hazard ratio, 1.06; 95% confidence interval, 0.31–3.60; p=0.923). The 2 groups had similar rates of death from any cause (0.1% in each group, p=0.789), MI (0.3% and 0.1%, respectively; p=0.226), repeat PCI (0.1% and 0.3%, respectively; p=0.548), stent thrombosis (0.1% and 0%, respectively; p=0.121), major bleeding (0.2% in each group, p=0.974), and major adverse cardiovascular and cerebrovascular events (0.5% in each group, p=0.924).CONCLUSIONS: Monotherapy with clopidogrel, compared to aspirin, after DAPT showed similar clinical outcomes in patients with acute MI treated with DES.


Assuntos
Aspirina , Stents Farmacológicos , Hemorragia , Humanos , Incidência , Coreia (Geográfico) , Infarto do Miocárdio , Intervenção Coronária Percutânea , Inibidores da Agregação de Plaquetas , Stents , Acidente Vascular Cerebral , Trombose
9.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-786213

RESUMO

BACKGROUND AND OBJECTIVES: Antiarrhythmic effect of renal denervation (RDN) after acute myocardial infarction (AMI) remains unclear. The goal of this study was to evaluate the effect of RDN on ventricular arrhythmia (VA) after AMI in a porcine model.METHODS: Twenty pigs were randomly divided into 2 groups based on RDN (RDN, n=10; Sham, n=10). After implanting a loop recorder, AMI was induced by occlusion of the middle left anterior descending coronary artery. Catheter-based RDN was performed for each renal artery immediately after creating AMI. Sham procedure used the same method, but a radiofrequency current was not delivered. Electrocardiography was monitored for 1 hour to observe VA. One week later, the animals were euthanized and the loop recorder data were analyzed.RESULTS: Ventricular fibrillation event rate and the interval from AMI creation to first VA in acute phase were not different between the 2 groups. However, the incidence of premature ventricular complex (PVC) was lower in the RDN than in the Sham. Additionally, RDN inhibited prolongation of the corrected QT (QTc) interval after AMI. The frequency of non-sustained or sustained ventricular tachycardia, arrhythmic death was lower in the RDN group in the early period.CONCLUSIONS: RDN reduced the incidence of PVC, inhibited prolongation of the QTc interval, and reduced VA in the early period following an AMI. These results suggest that RDN might be a therapeutic option in patients with electrical instability after AMI.


Assuntos
Animais , Arritmias Cardíacas , Denervação Autônoma , Vasos Coronários , Denervação , Eletrocardiografia , Humanos , Incidência , Métodos , Infarto do Miocárdio , Artéria Renal , Suínos , Taquicardia Ventricular , Fibrilação Ventricular , Complexos Ventriculares Prematuros
10.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-786145

RESUMO

OBJECTIVE: Axial spondyloarthritis (axSpA) is often accompanied by cardiac manifestations, such as valvular heart disease. In this prospective cohort study, we evaluated the incidence of cardiac abnormalities in Korean axSpA patients by echocardiography.METHODS: AxSpA patients were prospectively recruited from a single tertiary hospital. Baseline demographic, clinical, radiographic, and echocardiographic data were collected at the time of enrollment. Echocardiography evaluations were performed with a focus on valvular heart disease and systolic and diastolic function. Logistic regression analyses were used to identify factors associated with diastolic dysfunction in axSpA.RESULTS: A total of 357 axSpA patients were included in the analyses, of whom 78 (21.8%) exhibited diastolic dysfunction, with no reports of systolic dysfunction. Thirteen patients (3.6%) had valvular heart disease, and aortic valve regurgitation (n=5) and mitral valve regurgitation (n=6) were most common. Multivariable logistic regression analyses indicated that older age and higher body mass index (BMI) were positively associated with diastolic dysfunction, whereas human leukocyte antigen (HLA)-B27 positivity was negatively associated with diastolic dysfunction.CONCLUSION: Valvular heart disease is infrequent in Korean axSpA patients. However, diastolic dysfunction is common in axSpA patients, and is significantly associated with older age, higher BMI, and HLA-B27.


Assuntos
Valva Aórtica , Índice de Massa Corporal , Estudos de Coortes , Ecocardiografia , Insuficiência Cardíaca Diastólica , Doenças das Valvas Cardíacas , Antígeno HLA-B27 , Humanos , Incidência , Coreia (Geográfico) , Leucócitos , Modelos Logísticos , Insuficiência da Valva Mitral , Estudos Prospectivos , Espondiloartropatias , Centros de Atenção Terciária
11.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-786076

RESUMO

Cardiovascular disease (CVD), which is the leading cause of death worldwide, is strongly affected by diet. Diet can affect CVD directly by modulating the composition of vascular plaques, and indirectly by affecting the rate of aging. This review summarizes research on the relationships of fasting, meal timing, and meal frequency with CVD incidence and progression. Relevant basic research studies, epidemiological studies, and clinical studies are highlighted. In particular, we discuss both intermittent and periodic fasting interventions with the potential to prevent and treat CVD.


Assuntos
Envelhecimento , Pressão Sanguínea , Restrição Calórica , Doenças Cardiovasculares , Causas de Morte , Dieta , Estudos Epidemiológicos , Jejum , Incidência , Refeições
12.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-786073

RESUMO

OBJECTIVE: Total ceramide concentrations are linked with increased insulin resistance and cardiac dysfunction. However, recent studies have demonstrated that plasma concentrations of specific very-long-chain fatty ceramides (C24:0 and C22:0) are associated with a reduced incidence of coronary heart disease and all-cause mortality. We hypothesized that specific genetic loci are associated with plasma C22:0 and C24:0 concentrations.METHODS: Heritability and genome-wide association studies of plasma C24:0 and C22:0 ceramide concentrations were performed among 2,217 participants in the Framingham Heart Study Offspring Cohort, adjusting for cardiovascular risk factor covariates and cardiovascular drug treatment.RESULTS: The multivariable-adjusted heritability for C22:0 and C24:0 ceramides was 0.42 (standard error [SE], 0.07; p=1.8E-9) and 0.25 (SE, 0.08; p=0.00025), respectively. Nineteen single nucleotide polymorphisms (SNPs), all on chromosome 20, significantly associated with C22:0 concentrations; the closest gene to these variants was SPTLC3. The lead SNP (rs4814175) significantly associated with 3% lower plasma C22:0 concentrations (p=2.83E-11). Nine SNPs, all on chromosome 20 and close to SPTLC3, were significantly associated with C24:0 ceramide concentrations. All 9 were also significantly related to plasma C22:0 levels. The lead SNP (rs168622) was significantly associated with 10% lower plasma C24:0 ceramide concentrations (p=9.94E-09).CONCLUSION: SNPs near the SPTLC3 gene, which encodes serine palmitoyltransferase long chain base subunit 3 (SPTLC3; part of the enzyme that catalyzes the rate-limiting step of de novo sphingolipid synthesis) were associated with plasma C22:0 and C24:0 ceramide concentrations. These results are biologically plausible and suggest that SPTLC3 may be a potential therapeutic target for C24:0 and C22:0 ceramide modulation.


Assuntos
Doenças Cardiovasculares , Ceramidas , Cromossomos Humanos Par 20 , Estudos de Coortes , Doença das Coronárias , Loci Gênicos , Estudo de Associação Genômica Ampla , Genômica , Coração , Incidência , Resistência à Insulina , Mortalidade , Plasma , Polimorfismo de Nucleotídeo Único , Fatores de Risco , Serina C-Palmitoiltransferase
13.
Asia Pacific Allergy ; (4): 1-2020.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-785464

RESUMO

BACKGROUND: In the Emergency Department (ED), diagnosis and management of anaphylaxis are challenging with at least 50% of anaphylaxis episodes misdiagnosed when the diagnostic criteria of current guidelines are not used.OBJECTIVE: Objective of our study was to assess anaphylaxis diagnosis and management in patients presenting to the ED.METHODS: Retrospective chart review conducted on patients presenting to The Medical City Hospital ED, the Philippines from 2013–2015 was done. Cases were identified based on International Statistical Classification of Diseases, 10th revision coding for either anaphylaxis or other allergic related diagnosis. Cases fitting the definition of anaphylaxis as identified by the National Institute of Allergy and Infectious Disease and the Food Allergy and Anaphylaxis Network (NIAID/FAAN) were included. Data collected included demographics, signs and symptoms, triggers and management.RESULTS: A total of 105 cases were evaluated. Incidence of anaphylaxis for the 3-year study period was 0.03%. Of the 105 cases, 35 (33%) were diagnosed as “urticaria” or “hypersensitivity reaction” despite fulfilling the NIAID/FAAN anaphylaxis criteria. There was a significant difference in epinephrine administration between those given the diagnosis of anaphylaxis versus misdiagnosed cases (61 [87%] vs. 12 [34%], χ² = 30.77, p < 0.01); and a significant difference in time interval from arrival at the ED to epinephrine administration, with those diagnosed as anaphylaxis (48%) receiving epinephrine within 10 minutes, versus ≥ 60 minutes for most of the misdiagnosed group (χ² = 52.97, p < 0.01).CONCLUSION: Despite current guidelines, anaphylaxis is still misdiagnosed in the ED. Having an ED diagnosis of anaphylaxis significantly increases the likelihood of epinephrine administration, and at a shorter time interval.


Assuntos
Anafilaxia , Classificação , Codificação Clínica , Doenças Transmissíveis , Demografia , Diagnóstico , Emergências , Serviço Hospitalar de Emergência , Epinefrina , Hipersensibilidade Alimentar , Hospitais Urbanos , Humanos , Hipersensibilidade , Incidência , Filipinas , Estudos Retrospectivos , Centros de Atenção Terciária
14.
Asia Pacific Allergy ; (4): 7-2020.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-785458

RESUMO

BACKGROUND: The incidence of asthma exacerbation (AE) and the predictive value of spirometry and fractional exhaled nitric oxide (FeNO) in school children have not been evaluated.OBJECTIVE: We sought to evaluate the efficacy of spirometry measurement and FeNO monitoring for predicting AE in school children in the Cheongju area in Korea.METHODS: With parental agreement, we studied 170 students aged 7–12 years. Children were evaluated by an asthma specialist using baseline spirometry, skin prick test, seasonal FeNO measurement, and asthma control test. The study participants underwent a physical examination and their medical history was also evaluated by the specialist. They were assessed for asthma control status during regular doctor visits for 1 year.RESULTS: In total, 160 children (94.1%) completed follow-up and FeNO monitoring. Of which, 26 children (16.3%) had AE. AE was associated with male children and children with allergic rhinitis (p < 0.05). While, children with AE tended to have higher FeNO than those without AE, no significant difference was found. The maximum value of FeNO ≥35 ppb was associated with AE (p < 0.05). Children with AE had a significantly decreased baseline forced expiratory volume in 1 second/forced vital capacity (FEV₁/FVC), %predicted, forced expiratory flow at 25%–75% of FVC (FEF(25%–75%)). FEV₁/FVC < 80% was associated with AE in children regardless of inhalant allergen sensitization (all p < 0.05).CONCLUSION: Baseline spirometry had a predictive value of AE in school children. Sensitive spirometric parameters such as FEV₁/FVC and FEF(25%–75%) can be used as prognostic factors to predict future childhood AE. FeNO value ≥ 35 ppb during monitoring was associated with AE in school children.


Assuntos
Asma , Criança , Seguimentos , Volume Expiratório Forçado , Humanos , Incidência , Coreia (Geográfico) , Masculino , Óxido Nítrico , Pais , Exame Físico , Rinite Alérgica , Estações do Ano , Pele , Especialização , Espirometria , Capacidade Vital
15.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-785430

RESUMO

PURPOSE: Hepatorenal syndrome (HRS) is a fatal complication in patients with end-stage liver disease awaiting liver transplantation (LT). HRS often develops in patients with high model for end-stage liver disease (MELD) score. This study investigated the outcomes of peritransplant management of HRS in a high-volume LT center in Korea for 2 years.METHODS: A total of 157 recipients that deceased donor liver transplantation (DDLT) from January 2017 to December 2018 were included. In-hospital mortality (IHM) was analyzed in relation to pre- and posttransplant application of renal replacement therapy (RRT).RESULTS: Primary diagnoses for DDLT were alcoholic liver disease (n = 61), HBV-associated liver cirrhosis (n = 48), retransplantation for chronic graft failure (n = 24), and others (n = 24). Mean MELD score was 34.6 ± 6.2 with 72 patients at Korean Network for Organ Sharing MELD status 2 (45.9%), 43 at status 3 (27.4%), 36 at status 4 (22.9%), and 6 at status 5 (3.8%). Pretransplant RRT was performed in 16 patients (10.2%) that did not show IHM. Posttransplant RRT was performed in 69 patients (44.0%), for whom IHM incidence was 15.9%. In 53 patients that had undergone de novo posttransplant RRT, IHM incidence increased to 20.8%. IHM in the 88 patients not requiring RRT was 2.3%.CONCLUSION: The majority of adult DDLT recipients in Korean MELD score-based allocation system have very high MELD scores, which is often associated with HRS. Pretransplant RRT appears to improve posttransplant survival outcomes. We thereby recommend that, if indicated, pretransplant RRT be performed while awaiting DDLT.


Assuntos
Adulto , Diagnóstico , Síndrome Hepatorrenal , Mortalidade Hospitalar , Humanos , Incidência , Coreia (Geográfico) , Cirrose Hepática , Hepatopatias , Hepatopatias Alcoólicas , Transplante de Fígado , Fígado , Diálise Renal , Terapia de Substituição Renal , Doadores de Tecidos , Transplantes
16.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-811448

RESUMO

PURPOSE: The first aim of this study was to retrospectively survey sports injuries among 608 athletes participating in 26 sport events. The second aim was to compare the characteristics of sports injuries depending on the occurrences during the high school and university periods.METHODS: The data were collected based on the daily injury report form proposed by the International Olympic Committee from March to June 2019.RESULTS: Four hundred and thirty-nine athletes (313 men) of 608 participated athletes experienced a total of 747 sports injuries, indicating 0.7 injuries per 1,000 athlete exposures (AEs). The incidence rate during the university period was 6.1 injuries/1,000 AEs, which was approximately two-fold higher than that during the high school period (2.8 injuries/1,000 AEs). The reported frequency of injuries was the highest among long distance athletics (n=60, 8.0%), and in each subgroup as well.CONCLUSION: Many more injuries were incurred during practice wherein injuries in long-distance athletics were the most common than in competition athletics; handball injuries and taekwondo injuries were the most common during high school and university, respectively. The most contact injuries occurred in taekwondo and most noncontact injuries occurred in gymnastics during high school and in badminton during university. The most commonly affected body parts were the knee, shoulder, and ankle. Severe injuries were the most frequent in long distance athletics, and emergent situations were the most common in taekwondo.


Assuntos
Tornozelo , Atletas , Traumatismos em Atletas , Ginástica , Corpo Humano , Humanos , Incidência , Joelho , Esportes com Raquete , Estudos Retrospectivos , Ombro , Esportes
17.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-811446

RESUMO

Optimal bowel preparation is essential for a more accurate, comfortable, and safe colonoscopy. The majority of postcolonoscopy colorectal cancers can be explained by procedural factors, mainly missed polyps or inadequate examination. Therefore the most important goal of optimal bowel preparation is to reduce the incidence of colorectal cancer. Although adequate preparation should be achieved in 85–90% or more of all colonoscopy as a quality indicator, unfortunately 20–30% shows inadequate preparation. Laxatives for oral colonoscopy bowel preparation can be classified into polyethylene glycol (PEG)-electrolyte lavage solution, osmotic laxatives, stimulant laxatives, and divided into high-volume solution (≥3 L) and low-volume solution (<3 L). The updated 2019 European Society of Gastrointestinal Endoscopy (ESGE) guideline is broadly similar to the 2014 American Society for Gastrointestinal Endoscopy (ASGE) recommendations and reaffirms the importance of split-dosing. However, new ESGE guideline, unlike the 2014 ASGE recommendation, suggests the use of high volume or low volume PEG-based regimens as well as that of non-PEG based agents that have been clinically validated for most outpatient scenarios. For effective, safe, and highly adherent bowel preparation, physicians who prescribe and implement colonoscopy should properly know the advantages and limitations, the dosing, and the timing of regimens. Recently many studies have attempted to find the most ideal regimens, and more convenient, effective, and safe regimens have been developed by reducing the dosing volume and improving the taste. The high tolerability and acceptability of the new low-volume regimens suggest us how we should use it to increase the participation of the national colorectal cancer screening program.


Assuntos
Colonoscopia , Neoplasias Colorretais , Endoscopia Gastrointestinal , Humanos , Incidência , Laxantes , Programas de Rastreamento , Pacientes Ambulatoriais , Polietilenoglicóis , Pólipos , Irrigação Terapêutica
18.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811441

RESUMO

Hepatic hydrothorax is a transudative pleural effusion that complicates advanced liver cirrhosis. Patients refractory to medical treatment plus salt restriction and diuretics are considered to have refractory hepatic hydrothorax and may require transjugular intrahepatic portosystemic shunt (TIPS) or liver transplant. Successful antiviral therapy reduces the incidence of some complications of cirrhosis secondary to HCV infection. We report a case of hepatic hydrothorax in a 55-year-old female patient with HCV cirrhosis, which exhibited a spontaneous decrease in pleural effusion after direct antiviral agent (DAA) therapy. In cases of HCV cirrhosis, DAAs are worth administering before treatment by TIPS or liver transplantation.


Assuntos
Antivirais , Diuréticos , Feminino , Fibrose , Hepacivirus , Hepatite C Crônica , Hepatite Crônica , Humanos , Hidrotórax , Incidência , Fígado , Cirrose Hepática , Transplante de Fígado , Pessoa de Meia-Idade , Derrame Pleural , Derivação Portossistêmica Cirúrgica
19.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wprim-811430

RESUMO

OBJECTIVES: The purpose of this study was to determine the incidence of radix molaris (RM) (entomolaris and paramolaris) in the mandibular first permanent molars of a sample Saudi Arabian subpopulation using cone-beam computed tomography (CBCT).MATERIALS AND METHODS: A total of 884 CBCT images of 427 male and 457 female Saudi citizens (age 16 to 70 years) were collected from the radiology department archives of 4 dental centers. A total of 450 CBCT images of 741 mature mandibular first molars that met the inclusion criteria were reviewed. The images were viewed at high resolution by 3 examiners and were analyzed with Planmeca Romexis software (version 5.2).RESULTS: Thirty-three (4.5%) mandibular first permanent molars had RM, mostly on the distal side. The incidence of radix entomolaris (EM) was 4.3%, while that of radix paramolaris was 0.3%. The RM roots had one canal and occurred more unilaterally. No significant difference in root configuration was found between males and females (p > 0.05). Types I and III EM root canal configurations were most common, while type B was the only RP configuration observed.CONCLUSIONS: The incidence of RM in the mandibular first molars of this Saudi subpopulation was 4.5%. Identification of the supernumerary root can avoid missing the canal associated with the root during root canal treatment.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Cavidade Pulpar , Feminino , Humanos , Incidência , Masculino , Dente Molar , Prevalência
20.
Artigo em Coreano | WPRIM (Pacífico Ocidental) | ID: wprim-811372

RESUMO

OBJECTIVES: This study examined the association of the total diet quality with the incidence risk of metabolic syndrome constituents and metabolic syndrome among Korean adults.METHODS: Based on a community-based cohort of the Korean Genome and Epidemiology Study (KoGES) from 2001 to 2014, data from a total of 5,549 subjects (2,805 men & 2,744 women) aged 40~69 years at the baseline with a total follow-up period of 38,166 person-years were analyzed. The criteria of the National Cholesterol Education Program Adult Treatment Panel was employed to define metabolic syndrome. The total diet quality was estimated using the Korean Healthy Eating Index (KHEI). Hazard ratios (HR) and 95% confidence intervals (CI) for risk of metabolic syndrome constituents and metabolic syndrome in relation to KHEI quintile groups was calculated by multivariate Cox proportional hazards regression model.RESULTS: After adjusting for age, energy intake, income, education, physical activity, smoking, and drinking, the incidence of abdominal obesity and high blood pressure was significantly lower, by approximately 29.7% (P < 0.01) and 25.2% (P < 0.01), respectively, in the fifth KHEI quintile compared to the first quintile in men. A significant decreasing trend of the metabolic syndrome incidence was observed across the improving levels of KHEI (HRq5vs.q1: 0.775, 95% CIq5vs.q1: 0.619~0.971, P for trend < 0.01). In women, the incidence of abdominal obesity and metabolic syndrome was significantly lower, by approximately 29.8% (P < 0.01) and 22.5% (P < 0.05), respectively, in the fifth KHEI quintile compared to the first quintile adjusting for multiple covariates. On the other hand, the linear trend of metabolic syndrome risk across the KHEI levels did not reach the significance level.CONCLUSIONS: A better diet quality can prevent future metabolic syndrome and its certain risk factors among Korean men and women.


Assuntos
Adulto , Colesterol , Estudos de Coortes , Dieta , Ingestão de Líquidos , Ingestão de Alimentos , Educação , Ingestão de Energia , Epidemiologia , Feminino , Seguimentos , Genoma , Mãos , Humanos , Hipertensão , Incidência , Masculino , Obesidade Abdominal , Educação Física e Treinamento , Estudos Prospectivos , Fatores de Risco , Fumaça , Fumar
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