RESUMO
Emerging evidence reveals a strong association between COVID-19 and obesity in terms of disease severity, need for hospitalisation and risk of mortality. In this review, we discuss cellular and molecular mechanisms potentially contributing to the pathophysiology of COVID-19 in obese patients. Understanding the relationship between COVID-19 and obesity is pertinent for the clinical management of these patients.
Assuntos
COVID-19 , Obesidade , COVID-19/metabolismo , COVID-19/mortalidade , COVID-19/terapia , Humanos , Mortalidade , Obesidade/epidemiologia , Obesidade/virologia , Fatores de Risco , SARS-CoV-2 , Índice de Gravidade de DoençaRESUMO
Emerging evidence reveals a strong association between COVID-19 and obesity in terms of disease severity, need for hospitalisation and risk of mortality. In this review, we discuss cellular and molecular mechanisms potentially contributing to the pathophysiology of COVID-19 in obese patients. Understanding the relationship between COVID-19 and obesity is pertinent for the clinical management of these patients.
Assuntos
COVID-19/fisiopatologia , Inflamação/fisiopatologia , Obesidade/fisiopatologia , Índice de Gravidade de Doença , Índice de Massa Corporal , COVID-19/metabolismo , Progressão da Doença , Suscetibilidade a Doenças , Humanos , Imunidade Inata , Inflamação/metabolismo , Obesidade/metabolismo , Fatores de Risco , África do SulRESUMO
Intradialysis hypotension is a common problem, especially in patients with poor left-ventricular function. We studied 6 patients who were on maintenance hemodialysis with left-ventricular ejection fraction of <40%, whose dialysis sessions were often complicated with severe hypotension (systolic blood pressure <90 mm Hg). Dobutamine infusion during dialysis significantly reduced the number of hypotensive episodes, increased left-ventricular ejection fraction, and decreased the number of emergency admissions to the hospital.
Assuntos
Agonistas Adrenérgicos beta/uso terapêutico , Dobutamina/uso terapêutico , Hipotensão/tratamento farmacológico , Diálise Renal/efeitos adversos , Agonistas Adrenérgicos beta/administração & dosagem , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Dobutamina/administração & dosagem , Feminino , Humanos , Hipotensão/etiologia , Bombas de Infusão , Masculino , Pessoa de Meia-Idade , Função Ventricular Esquerda/fisiologiaRESUMO
A case of severe post burns contracture of the wrist, of 43 years duration resulting in recurrent ulceration of the skin was successfully treated by gradual distraction using the Ilizarov method. This method is superior to plaster of Paris cast and is more versatile than other forms of external fixation.
Assuntos
Queimaduras/complicações , Contratura/cirurgia , Técnica de Ilizarov , Traumatismos do Punho/cirurgia , Punho , Adulto , Queimaduras/diagnóstico por imagem , Queimaduras/cirurgia , Contratura/etiologia , Seguimentos , Humanos , Técnica de Ilizarov/instrumentação , Masculino , Radiografia , Recidiva , Úlcera Cutânea/complicações , Úlcera Cutânea/cirurgia , Punho/diagnóstico por imagem , Punho/cirurgia , Traumatismos do Punho/complicações , Traumatismos do Punho/diagnóstico por imagemRESUMO
Nutritional support is an important aspect of the management of burn patients. Nutrition supplementation can be achieved either by 'hospital-made' or 'commercial' diets. Commercial diets are efficacious but expensive and sometimes not easily available. This study was undertaken to compare the efficacy and tolerance of a hospital-made diet with a commercial diet. Twenty patients with burns ranging from 20-50 per cent TBSA were studied to compare the efficacy and tolerance of the 'hospital-made' diet with 'commercial' preparations. Patients were divided into two groups of 10 each and randomised within each group to receive either a hospital-made diet (five patients) or a commercial diet (five patients). Efficacy of diet was assessed by evaluation of nutritional status, graft take, number of surgical procedures and duration of hospital stay. Tolerance was assessed by recording side effects such as nausea, vomiting, abdominal distention and diarrhoea. Both diets were well tolerated by all patients. There was no significant difference in nutritional status, number of surgical procedures, percentage of graft take and duration of hospital stay on either diet, suggesting that hospital-made diets are similar in efficacy and tolerance but cheaper and more easily available. They are a good alternative to 'commercial' diets, especially in poor patients.
