RESUMO
Epidemiological research to identify subpopulations with enhanced susceptibility to air pollution is still at an early stage. From the available studies, there is evidence that both "endogenous" and "exogenous" factors contribute to individual susceptibility. Females and the elderly are at an increased risk of pollution-related diseases. Moreover, some chronic clinical conditions seem to be good candidates for identifying the "frail" populations: chronic obstructive pulmonary disease including asthma, coronary heart diseases, congestive heart failure, and heart rhythm disorders. It seems clear that epidemiological research on susceptibility in the future should investigate the underlying biological and physiological mechanisms, in addition to the environmental and toxicological effects.
Assuntos
Poluição do Ar/efeitos adversos , Pneumopatias/genética , Fatores Etários , Idoso , Criança , Estudos Epidemiológicos , Feminino , Predisposição Genética para Doença , Humanos , Pneumopatias/etiologia , Masculino , Fatores de Risco , Fatores SexuaisRESUMO
This prospective study, based on declaratory data, evaluates the appropriateness of red blood cell transfusion prescriptions in a university hospital. Local recommendations written after data collection and the analysis of prescriptions using a blinded method limited the bias related to the declaratory data. The results show that the rate of unjustified prescriptions is 4.2% (95% CI: 2.2%; 6.2%). This rate is statistically (P = 0.032) lower in the department of surgery (1.3%) than in the department of medicine (5.7%). This rate tends to decrease according to the experience of the prescriber (P = 0.06) and varies significantly according to the hemoglobin levels (P = 0.03). The logistic regression, integrating these three parameters, confirms that only the hemoglobin level is significantly related (P < 0.003) to the appropriateness of RBC transfusions. This study also highlights problems not linked to prescriptions, and the hospital created a quality assurance program as a result.