Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Stents Farmacológicos , Síndrome de Kounis/diagnóstico , Acetaminofen/efeitos adversos , Idoso , Antipirina/efeitos adversos , Antipirina/análogos & derivados , Diabetes Mellitus Tipo 2 , Diagnóstico Diferencial , Quimioterapia Combinada , Humanos , Hipertensão , Síndrome de Kounis/diagnóstico por imagem , Síndrome de Kounis/etiologia , MasculinoRESUMO
BACKGROUND: Driving performance is known to be very sensitive to cognitive-psychomotor impairment. The aim of the study was to determine the relationship between obesity, risk of obstructive sleep apnoea (OSA), daytime sleepiness, history of road traffic accident (RTA) and performance on a driving simulator, among commercial drivers. METHODS: We examined commercial vehicle drivers admitted to Psycho-Technical Assessment System (PTAS), which is a computer-aided system that includes a driving simulator test and tests assessing psychomotor-cognitive skills required for driving. Risk of OSA and daytime sleepiness were assessed by the Berlin Questionnaire and the Epworth Sleepiness Scale (ESS), respectively. RESULTS: A total of 282 commercial vehicle drivers were consecutively enrolled. The age range was 29-76 years. Thirty drivers were at high risk of OSA. Median ESS of the group was 2 (0-20). Forty-seven percent of the subjects at high risk of OSA failed in early reaction time test, while 28% of the drivers with low risk of OSA failed (p = 0.03). The obese drivers failed the peripheral vision test when compared with non-obese drivers (p = 0.02). ESS was higher for drivers with a history of RTA when compared to those without RTA (p = 0.02). CONCLUSIONS: Cognitive-psychomotor functions can be impaired in obese and high risk of OSA patients. In our opinion, requiring obese and/or high risk of OSA drivers to take PTAS tests that assess driving skills and psychomotor-cognitive functions crucial to those skills would significantly improve road traffic safety, which is of considerable importance to public health.
Assuntos
Acidentes de Trânsito/estatística & dados numéricos , Condução de Veículo/estatística & dados numéricos , Simulação por Computador , Distúrbios do Sono por Sonolência Excessiva/diagnóstico , Distúrbios do Sono por Sonolência Excessiva/epidemiologia , Veículos Automotores , Obesidade/epidemiologia , Doenças Profissionais/epidemiologia , Doenças Profissionais/fisiopatologia , Apneia Obstrutiva do Sono/epidemiologia , Apneia Obstrutiva do Sono/fisiopatologia , Adulto , Idoso , Atenção/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Obesidade/diagnóstico , Doenças Profissionais/diagnóstico , Desempenho Psicomotor/fisiologia , Tempo de Reação/fisiologia , Fatores de Risco , Apneia Obstrutiva do Sono/diagnóstico , TurquiaRESUMO
OBJECTIVE: To evaluate the effect of pentaglobin treatment on clinical and laboratory parametres and the major morbidities in very low birthweight neonates with nosocomial sepsis before and after pentaglobin treatment. METHODS: The prospective interventional study was conducted from January 1 to December 31, 2010, at the neonatal intensive care unit (NICU) of the Bakirköy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey. Pentaglobin was initiated on the day of diagnosis of nosocomial sepsis to 13 pre-term neonates as a support therapy in addition to antibiotics; 5 ml/kg per day of pentaglobin was infused over a 4-hour period on 3 consecutive days. Clinical and laboratory parametres and major morbidities were recorded before and after pentaglobin treatment and compared using NCSS software. RESULTS: Of the total, 8 (66%) were females and 5 (40%) males. Following pentaglobin therapy, the immature-to-total neutrophil ratio and C-reactive protein levels were significantly decreased, and the capillary pH and base excess were significantly increased (p < 0.05). The axillary temperature, non-invasive blood pressure, haemoglobin, leukocyte, and thrombocyte values did not significantly differ before and after treatment (p > 0.05). Coagulase-negative staphylococci (n = 3; 23%), Klebsiella pneumoniae (n = 2; 15.3%), and Pseudomonas aeruginosa (n = 1; 7.7%) were identified in blood cultures. The presence of intraventricular haemorrhages, necrotising enterocolitis, periventricular leukomalacia, and patent ductus arteriosus was not changed following the treatment. Adverse effects and mortality were not observed during or after the therapy. CONCLUSION: Pentaglobin treatment of nosocomial sepsis could be used as an adjunct therapy without any adverse short-term reactions, even in very low birthweight pre-term infants.