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1.
Ann Lab Med ; 42(1): 24-35, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34374346

RESUMO

Background: Laboratory parameter abnormalities are commonly observed in COVID-19 patients; however, their clinical significance remains controversial. We assessed the prevalence, characteristics, and clinical impact of laboratory parameters in COVID-19 patients hospitalized in Daegu, Korea. Methods: We investigated the clinical and laboratory parameters of 1,952 COVID-19 patients on admission in nine hospitals in Daegu, Korea. The average patient age was 58.1 years, and 700 (35.9%) patients were men. The patients were classified into mild (N=1,612), moderate (N=294), and severe (N=46) disease groups based on clinical severity scores. We used chi-square test, multiple comparison analysis, and multinomial logistic regression to evaluate the correlation between laboratory parameters and disease severity. Results: Laboratory parameters on admission in the three disease groups were significantly different in terms of hematologic (Hb, Hct, white blood cell count, lymphocyte%, and platelet count), coagulation (prothrombin time and activated partial thromboplastin time), biochemical (albumin, aspartate aminotransferase, alanine aminotransferase, lactate, blood urea nitrogen, creatinine, and electrolytes), inflammatory (C-reactive protein and procalcitonin), cardiac (creatinine kinase MB isoenzyme and troponin I), and molecular virologic (Ct value of SARS-CoV-2 RdRP gene) parameters. Relative lymphopenia, prothrombin time prolongation, and hypoalbuminemia were significant indicators of COVID-19 severity. Patients with both hypoalbuminemia and lymphopenia had a higher risk of severe COVID-19. Conclusions: Laboratory parameter abnormalities on admission are common, are significantly associated with clinical severity, and can serve as independent predictors of COVID-19 severity. Monitoring the laboratory parameters, including albumin and lymphocyte count, is crucial for timely treatment of COVID-19.


Assuntos
COVID-19 , Análise de Dados , Humanos , Laboratórios , Masculino , Pessoa de Meia-Idade , República da Coreia/epidemiologia , Estudos Retrospectivos , SARS-CoV-2
2.
Esc. Anna Nery Rev. Enferm ; 26(spe): e20210179, 2022. ilus
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1292850

RESUMO

Objetivo: O estudo objetivou compreender as repercussões da pandemia da Covid-19 no cuidado de lactentes prematuros, na perspectiva de mães e profissionais de saúde. Método: Foram realizadas entrevistas semiestruturadas nos meses de junho e julho de 2020, por meio de ligação telefônica, com 14 mães e quatro profissionais de saúde do serviço de follow-up de uma maternidade pública da Paraíba, Brasil. Resultados: A partir da análise temática indutiva, os impactos da pandemia no cuidado ao lactente nascido prematuro, foram: sobrecarga e afastamento dos profissionais dos serviços de saúde, desativação temporária da unidade mãe canguru, descontinuidade da assistência ao prematuro, medo materno de expor a criança à Covid-19 e baixa condição socioeconômica. Foram elencadas estratégias de enfrentamento para o cuidado dos lactentes durante a pandemia, como: maior espaçamento das consultas, acompanhamento por meio telefônico e cumprimento das medidas de biossegurança. Conclusão e implicações para a prática: A pandemia exigi adaptações na assistência, tornando necessárias novas formas de cuidado a essas crianças, como exemplo, as consultas de acompanhamento remotas, a fim de garantir o seu direito à vida e saúde


Objective: The study aimed at understanding the repercussions of the Covid-19 pandemic in the care of premature infants, from the perspective of mothers and health professionals. Method: Semi-structured interviews were conducted in the months of June and July 2020, over the telephone, with 14 mothers and four health professionals from the follow-up service of a public maternity hospital in Paraíba, Brazil. Results: From the inductive thematic analysis, the impacts of the pandemic on the care of premature infants were as follows: overload and distancing of health service professionals, temporary deactivation of the Kangaroo mother unit, discontinuity of care for the premature infant, maternal fear of exposing the child to Covid-19 and low socioeconomic status. Coping strategies for the care of infants during the pandemic were listed, such as: greater spacing between consultations, phone follow-up and compliance with biosafety measures. Conclusion and implications for the practice: The pandemic required adaptations in care, which make new forms of care necessary for these children, such as remote follow-up consultations, in order to guarantee their right to life and health


Objetivo: El estudio tuvo como objetivo comprender las repercusiones de la pandemia de Covid-19 en la atención de bebés prematuros, desde la perspectiva de las madres y los profesionales de la salud. Método: Se realizaron entrevistas semiestructuradas en los meses de junio y julio de 2020, por medio de llamadas telefónicas, a 14 madres y cuatro profesionales de la salud del servicio de seguimiento de una maternidad pública en Paraíba, Brasil. Resultados: A partir del análisis temático inductivo, los efectos de la pandemia en la atención de bebés prematuros fueron los siguientes: sobrecarga y distanciamiento de profesionales de los servicios de salud, inhabilitación temporal de la unidad Madre Canguro, discontinuidad de la atención al bebé prematuro, miedo materno a exponer al niño al Covid-19 y nivel socioeconómico bajo. Se enumeraron estrategias de afrontamiento para la atención infantil durante la pandemia, tales como: mayor intervalo entre consultas, seguimiento telefónico y cumplimiento de medidas de bioseguridad. Conclusión e implicaciones para la práctica: La pandemia requirió adaptaciones en la atención, que hacen necesarias nuevas formas de atención para estos niños, como las consultas de monitoreo remoto, para garantizar su derecho a la vida y a la salud


Assuntos
Humanos , Feminino , Lactente , Adulto , Pessoa de Meia-Idade , Recém-Nascido Prematuro/crescimento & desenvolvimento , Pessoal de Saúde , Serviços de Saúde Materno-Infantil , COVID-19 , Cuidado do Lactente , Mães , Carga de Trabalho/psicologia , Consulta Remota , Pesquisa Qualitativa , Cobertura Vacinal , Medo , Método Canguru , Higiene das Mãos , Distanciamento Físico , COVID-19/prevenção & controle
3.
Gene ; 806: 145935, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34478821

RESUMO

Soluble molecules of programmed death ligand 1 (sPD-L1) are known to modulate T-cell depletion, an important mechanism of hepatitis B virus (HBV) persistence and liver disease progression. In addition, PD-L1 polymorphisms in the 3'-UTR can influence PD-L1 expression and have been associated with cancer risk, although not definitively. The purpose of this study was to investigate the association of PD-L1 polymorphisms and circulating levels of sPD-L1 in HBV infection and live disease progression. In this study, five hundred fifty-one HBV infected patients of the three clinically well-defined subgroups chronic hepatitis B (CHB, n = 186), liver cirrhosis (LC, n = 142) and hepatocellular carcinoma (HCC, n = 223) and 240 healthy individuals (HC) were enrolled. PD-L1 polymorphisms (rs2297136 and rs4143815) were genotyped by in-house validated ARMS assays. Logistic regression models were applied in order to determine the association of PD-L1 polymorphisms with HBV infection as well as with progression of related liver diseases. Plasma sPD-L1 levels were quantified by ELISA assays. The PD-L1 rs2297136 AA genotype was associated with HBV infection susceptibility (HBV vs. HC: OR = 1.6; 95%CI = 1.1-2.3; p = 0.0087) and disease progression (LC vs. CHB: OR = 1.8; 95%CI = 1.1-2.9; p = 0.018). Whereas, the rs2297136 GG genotype was a protective factor for HCC development. Plasma sPD-L1 levels were significantly high in HBV patients (p < 0.0001) and higher in the LC followed by CHB and HCC groups. High sPD-L1 levels correlated with increased liver enzymes and with advanced liver disease progression (Child-pugh C > B > A, p < 0.0001) and BCLC classification (BCLC D > C > B > A, p = 0.031). We could, for the first time, conclude that PD-L1 rs2297136 polymorphism and plasma sPD-L1 protein levels associate with HBV infection and HBV-related liver disease progression.


Assuntos
Antígeno B7-H1/genética , Carcinoma Hepatocelular/genética , Vírus da Hepatite B/patogenicidade , Hepatite B Crônica/genética , Cirrose Hepática/genética , Neoplasias Hepáticas/genética , Polimorfismo Genético , Regiões 3' não Traduzidas , Adulto , Idoso , Antígeno B7-H1/sangue , Biomarcadores/sangue , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/etiologia , Carcinoma Hepatocelular/virologia , Estudos de Casos e Controles , Progressão da Doença , Feminino , Expressão Gênica , Predisposição Genética para Doença , Vírus da Hepatite B/crescimento & desenvolvimento , Hepatite B Crônica/complicações , Hepatite B Crônica/diagnóstico , Hepatite B Crônica/virologia , Humanos , Fígado/metabolismo , Fígado/patologia , Fígado/virologia , Cirrose Hepática/diagnóstico , Cirrose Hepática/etiologia , Cirrose Hepática/virologia , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/etiologia , Neoplasias Hepáticas/virologia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes
4.
Gene ; 807: 145951, 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-34500051

RESUMO

AIMS: The purpose of the present study was to analyze the role of selected polymorphisms of SIRT3 and SIRT5 in gastric carcinogenesis. METHODS: For this study, 500 blood samples of GC patients and 500 blood samples of healthy individuals were collected. Six selected polymorphisms of mitochondrial sirtuins were analyzed for analysis using Tetra-Arms PCR followed by DNA sequencing. RESULTS: Mutant allele frequencies of selected polymorphisms [rs3782116 (p < 0.0001), rs6598072 (p < 0.0001) and rs11246020 (p < 0.0001), rs938222 (p = 0.0136), rs3757261 (p = 0.0005) and rs2841511 (p = 0.0015)] were observed significant higher in GC patients vs controls. Haplotype analysis was performed, and 51 haplotypes were generated using haploview software. Among these haplotypes, eleven haplotypes were found associated with a significantly increased risk of GC. Furthermore, SNP-SNP interaction showed a significant correlation between studied SNPs and GC risk. Kaplan Meier analysis showed that mutant allele frequencies of selected polymorphisms are linked with a significant decrease in survival of GC patients CONCLUSIONS: It can be concluded that selected SNPs may be associated with enhanced risk of GC and hence can be potential prognostic markers for prognosis and predisposition of GC.


Assuntos
Sirtuína 3/genética , Sirtuínas/genética , Neoplasias Gástricas/genética , Alelos , Grupo com Ancestrais do Continente Asiático/genética , Estudos de Casos e Controles , China/epidemiologia , Feminino , Frequência do Gene/genética , Predisposição Genética para Doença/genética , Variação Genética/genética , Genótipo , Haplótipos , Humanos , Masculino , Pessoa de Meia-Idade , Mitocôndrias/genética , Polimorfismo de Nucleotídeo Único/genética , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Sirtuína 3/sangue , Sirtuína 3/metabolismo , Sirtuínas/sangue , Sirtuínas/metabolismo
5.
Gene ; 806: 145922, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34454032

RESUMO

Gastric cancer (GC)-derived cell lines were generally used in basic cancer research and drug screening. However, it is always concerned about the difference between cultured cells and primary tumor by oncologists. To address this question, we compared differentially expressed genes (DEGs) in primary cancers, healthy tissues, and cell lines both in vitro and in silico. Seven reported genes with decreased expression in GCs by DNA methylation were analyzed in our cohort studies and experimentally validation. Selected datasets from TCGA (The Cancer Genome Atlas), CCLE (The Broad Institute Cancer Cell Line Encyclopedia), and GTEx (The Genotype-Tissue Expression project) were used to represent GCs, GC-derived cell lines, and healthy tissues respectively in the in silico analysis. Thirty gastric tissues together with six cell lines were used for validations. Unexpectedly, we experimentally found that reported cancer-related downregulated genes were only found in cancer cell lines but not in biopsies. The unchanged gene expressions in primary GCs were generally consistent with our cohort study, using information from cancerous (TCGA) and healthy tissues (GETx). Substantial differences were also found between DEGs of cancer tissues (TGCA)/ healthy tissues (GTEx) pair and cell lines (CCLE)/ healthy tissues (GTEx) pair, which confirmed the significant differences between primary cancer and cancer cell lines. Moreover, elevated expression of YWHAQ (14-3-3 δ) and THBS1 were observed in the GC biopsies, which might be potential biomarkers for GC diagnosis, considering the increased YWHAQ and THBS1 associated with poor survival rates in gastric cancer patients. In sum, it is suggested that cautions should be taken when using GC cell lines to study genes that show great differences between cell lines and tissues.


Assuntos
Proteínas 14-3-3/genética , Regulação Neoplásica da Expressão Gênica , Proteínas de Neoplasias/genética , Neoplasias Gástricas/genética , Trombospondinas/genética , Proteínas 14-3-3/metabolismo , Idoso , Atlas como Assunto , Biomarcadores Tumorais/genética , Biomarcadores Tumorais/metabolismo , Linhagem Celular Tumoral , Metilação de DNA , Conjuntos de Dados como Assunto , Epigênese Genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Proteínas de Neoplasias/metabolismo , Cultura Primária de Células , Prognóstico , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Análise de Sobrevida , Trombospondinas/metabolismo , Células Tumorais Cultivadas
6.
Breast Dis ; 41(1): 1-3, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34219707

RESUMO

During the first hit of SARS-COVID pandemic, an important reorganization of Healthcare Services has been done, and new protocols and pathways to protect frail patients like oncological patients were designed. The second hit of pandemic had stressed these new pathways and suggests to health-workers some improvements for safer management of patents.We reported our experience in organizing the clinical pathway of neoadjuvant therapy candidate patients based on the execution of sentinel lympho-node biopsy and the placement of implantable venous access port in the same access to operating room before neoadjuvant chemotherapy suggesting a possible organizational model. In the period October-December 2020 we have included in this new type of path twelve patients and we have not registered any cases of COVID among the patients included. We think this new path, adopted amid the second hit, will be useful for all Breast Units that are facing the challenge of guaranteeing the highest standards of care in a historical moment where the health emergency occupies the efforts of health workers and the economic resources of health systems.


Assuntos
Antineoplásicos/administração & dosagem , Neoplasias da Mama/tratamento farmacológico , COVID-19/prevenção & controle , Cateterismo Venoso Central/métodos , Controle de Infecções/métodos , Segurança do Paciente , Biópsia de Linfonodo Sentinela/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Cateterismo Venoso Central/instrumentação , Cateterismo Venoso Central/normas , Cateteres Venosos Centrais , Quimioterapia Adjuvante , Procedimentos Clínicos , Feminino , Humanos , Controle de Infecções/normas , Mastectomia , Pessoa de Meia-Idade , Terapia Neoadjuvante , Estadiamento de Neoplasias , Biópsia de Linfonodo Sentinela/normas
7.
Talanta ; 237: 122926, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34736663

RESUMO

Selective and sensitive detection of cancer biomarkers in serum samples is critical for early diagnosis of cancer. Prostate specific antigen is an important biomarker of prostate cancer, which ranks high among cancer-related deaths of men over 50 years old. Herein, a novel analytical method was introduced for detection of PSA by combining high selectivity of molecularly-imprinted polymers and high sensitivity of surface-enhanced Raman spectroscopy (SERS). Firstly, magnetic nanoparticles were grafted with an imprinted layer by using tannic acid as a functional monomer, diethylenetriamine as a cross-linker and prostate specific antigen as a template molecule. Detailed surface characterization and re-binding experiment results indicated that the imprinting of the antigen was successful with an imprinting factor of 5.58. The prepared magnetic molecularly imprinted polymers (MMIPs) were used as an antibody-free capture probe and labeled with gold nanoparticles that were modified with anti-PSA and a Raman reporter, namely 5,5'-dithiobis-(2-nitrobenzoic acid). Thus, a plasmonic structure (sandwich complex) was formed between MMIP and the SERS label. The limit of detection and limit of quantification of the designed sensor were 0.9 pg/mL and 3.2 pg/mL, respectively. The sensor also showed high recovery rates (98.0-100.1% for healthy person and 99.0-101.3% for patient) with low standard deviations (less than 4.3% for healthy person and less than 3.3% for patient) for PSA in serum samples. Compared with the traditional immunoassays, the proposed method has several advantages like low cost, reduced detection procedure, fast response, high sensitivity and selectivity. It is believed that the proposed method can be potentially used for selective and sensitive determination of tumor marker of prostate cancer in clinical applications.


Assuntos
Técnicas Biossensoriais , Nanopartículas Metálicas , Impressão Molecular , Neoplasias da Próstata , Biomarcadores Tumorais , Ouro , Humanos , Fenômenos Magnéticos , Masculino , Pessoa de Meia-Idade , Polímeros Molecularmente Impressos , Polímeros , Antígeno Prostático Específico , Neoplasias da Próstata/diagnóstico , Análise Espectral Raman
8.
Esc. Anna Nery Rev. Enferm ; 26: e20210203, 2022. tab
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1339876

RESUMO

RESUMO Objetivo analisar as características individuais, clínicas e os fatores associados à mortalidade de pacientes com COVID-19, em hospital público do estado do Paraná, Brasil. Métodos estudo seccional, retrospectivo, documental (n= 86), com pacientes adultos internados, de março a junho de 2020. Resultados a mortalidade foi de 12,8%, o grupo de maior risco foi de idosos com comorbidades, especialmente, cardiovasculares. A chance de óbito foi 58 vezes maior em idosos, comparada aos adultos, e oito vezes maior naqueles com comorbidades, comparadas aos hígidos. A maioria dos pacientes apresentou sintomatologia respiratória, febre e mialgia. Tratamento à base de antibióticos, anticoagulantes e antivirais, associado ao suporte ventilatório. As principais complicações foram hipóxia, insuficiência renal aguda e infecção secundária. Conclusão e implicações para a prática idosos com comorbidades cardiovasculares que necessitaram de cuidados intensivos apresentaram maior chance de óbito. Os resultados de um dos centros de referência na pandemia possibilitam discutir medidas epidemiológicas adotadas, com ênfase em conceitos restritivos nos primeiros meses.


RESUMEN Objetivo analizar las características individuales, clínicas y los factores asociados a la mortalidad en pacientes con COVID-19 en un hospital público del estado de Paraná. Métodos estudio transversal, retrospectivo, documental (n = 86), con pacientes adultos hospitalizados, de marzo a junio de 2020. Resultados la mortalidad fue del 12,8%, grupo de mayor riesgo para los ancianos con comorbilidades, especialmente enfermedades cardiovasculares. La probabilidad de muerte fue 58 veces mayor en los ancianos en comparación con los adultos y ocho veces mayor en aquellos con comorbilidades en comparación con los sanos. La mayoría de los pacientes presentaban síntomas respiratorios, fiebre y mialgia. Tratamiento a base de antibióticos, anticoagulantes y antivirales, asociado al soporte ventilatorio. Las principales complicaciones fueron hipoxia, insuficiencia renal aguda e infección secundaria. Conclusión e implicaciones para la práctica los ancianos con comorbilidades cardiovasculares que requirieron cuidados intensivos tenían una mayor probabilidad de muerte. Los resultados de uno de los centros de referencia pandémica permiten discutir las medidas epidemiológicas adoptadas, con énfasis en conceptos restrictivos en los primeros meses.


ABSTRACT Objective to analyze the individual and clinical characteristics and the factors associated with mortality in patients with COVID-19, in a public hospital in the state of Paraná, Brazil. Methods a cross-sectional, retrospective, documentary study (n= 86), with adult inpatients, from March to June 2020. Results mortality was 12.8%, the highest risk group was the elderly with comorbidities, especially cardiovascular ones. The chance of death was 58 times higher in the elderly compared to adults, and eight times higher in those with comorbidities compared to the healthy ones. Most patients presented with respiratory symptoms, fever, and myalgia. Treatment was based on antibiotics, anticoagulants and antivirals, associated with ventilatory support. The main complications were hypoxia, acute renal failure, and secondary infection. Conclusion and implications for practice elderly people with cardiovascular comorbidities who required intensive care had a higher chance of death. The results from one of the reference centers in the pandemic make it possible to discuss epidemiological measures adopted, with emphasis on restrictive concepts in the first months.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Perfil de Saúde , Morte , SARS-CoV-2 , COVID-19/mortalidade , Respiração Artificial , Doenças Cardiovasculares , Comorbidade , Registros Médicos , Estudos Retrospectivos , Fatores de Risco , Azitromicina/uso terapêutico , COVID-19/tratamento farmacológico , Unidades de Terapia Intensiva , Tempo de Internação
9.
Esc. Anna Nery Rev. Enferm ; 26: e20210109, 2022.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1346058

RESUMO

Resumo Objetivo Analisar as percepções de enfermeiros sobre gestão do cuidado e seus fatores intervenientes para o controle da tuberculose na Atenção Primária em Saúde. Método Estudo descritivo, qualitativo, realizado com 29 enfermeiros que atuavam no controle da tuberculose em 23 Unidades Básicas de Saúde de Belém, Pará. Os dados foram produzidos por entrevistas individuais, utilizando roteiro semiestruturado, e submetidos à análise de conteúdo temática, proposta por Bardin. Resultados Originaram-se duas categorias temáticas: "A gestão do cuidado de enfermeiros para o controle da tuberculose nas Unidades Básicas de Saúde" e "Fatores intervenientes na efetivação da gestão do cuidado no controle da tuberculose nas Unidades Básicas de Saúde". Conclusão e implicações para a prática O conhecimento dos enfermeiros sobre a política e a gestão do cuidado no controle da tuberculose precisa ser fortalecido, e embora eles tenham clareza sobre suas competências, não conseguem realizá-las em sua plenitude por questões referentes à pouca organização dos serviços, centralização das atividades nos enfermeiros, baixa cooperação multiprofissional, falta de insumos e de pessoal e questões socioeconômicas ligadas ao usuário com tuberculose.


Resumen Objetivo Analizar la percepción de enfermeros sobre la gestión de la atención y los factores intervinientes para el control de la tuberculosis en la Atención Primaria de la Salud. Método Estudio descriptivo cualitativo realizado con 29 enfermeros que pre en el control de la tuberculosis en 23 Unidades Básicas de Salud de Belém, Pará. Los datos fueron producidos por entrevistas individuales, utilizando un guion semiestructurado, y sometido al análisis de contenido temático propuesto por Bardin. Resultados Se originaron dos categorías temáticas: "La gestión de la atención de enfermeros para el control de la tuberculosis en las Unidades Básicas de Salud" y "Factores intervinientes en la efectividad de la gestión de la atención en el control de la tuberculosis en las Unidades Básicas de Salud". Conclusión e implicaciones para la práctica Es necesario fortalecer el conocimiento de las enfermeras sobre la política y la gestión de la atención en el control de la tuberculosis, y aunque tienen claras sus competencias, no pueden implementarlas en su totalidad debido a problemas relacionados con la mala organización de los servicios, la centralización de actividades en los enfermeros, baja cooperación multiprofesional, falta de insumos y personal y aspectos socioeconómicos relacionados con el usuario con tuberculosis.


Abstract Objective To analyze nurses' perceptions on care management and its intervening factors for tuberculosis control in Primary Health Care. Method A descriptive and qualitative study conducted with 29 nurses who worked on tuberculosis control in 23 Basic Health Units in Belém, Pará. The data were produced by individual interviews, using a semi-structured script, and submitted to thematic content analysis, as proposed by Bardin. Results Two thematic categories emerged, namely: "Care management by nurses for tuberculosis control in Basic Health Units" and "Intervening factors in the application of care management for tuberculosis control in Basic Health Units". Conclusion and implications for the practice The nurses' knowledge about the care policy and management for tuberculosis control needs to be strengthened and, although nurses are aware of their competences, they are unable to fully implement them due to issues related to poor organization services, centralization of activities on them, low multiprofessional cooperation, scarcity of supplies and personnel, and socioeconomic issues related to tuberculosis patients.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Atenção Primária à Saúde , Tuberculose/prevenção & controle , Gestão em Saúde , Enfermeiras e Enfermeiros/psicologia , Prática Profissional , Apoio Social , Fatores Socioeconômicos , Tuberculose/enfermagem , Tuberculose/terapia , Educação em Saúde , Pesquisa Qualitativa , Vulnerabilidade em Saúde , Capacitação Profissional , Estigma Social , Cooperação e Adesão ao Tratamento , Cuidados de Enfermagem
10.
Esc. Anna Nery Rev. Enferm ; 26: e20210141, 2022. tab, graf
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1346057

RESUMO

Resumo Objetivo comparar atitudes relacionadas à colaboração interprofissional autorrelatadas por diferentes equipes da atenção primária com a realidade observada de seus processos de trabalho. Método abordagem qualitativa e quantitativa implementada em duas etapas de coleta de dados, entre dezembro de 2019 e outubro de 2020. Na qualitativa, empregou-se a observação sistemática dos atendimentos em unidades de saúde. Utilizou-se roteiro de observação baseado no Referencial para Competências em Interprofissionalidade e no Fluxograma Analisador do processo de trabalho centrado no usuário. As observações foram registradas em diário de campo. Na etapa quantitativa, aplicou-se a Escala de Atitudes Relacionadas à Colaboração Interprofissional. Resultados noventa e um profissionais da atenção básica responderam a escala. Obteve-se uma média de 120 de pontuação, que significa valorização do trabalho colaborativo por respondentes de todas as equipes. Apesar disso, foram observadas divergências entre o falado e o vivido, pois o processo de trabalho estruturado parece limitar atitudes colaborativas. Conclusões e implicações para a prática valorização de atividades programadas para o trabalho interprofissional da equipe de saúde e de enfermagem na atenção primária, como espaços na agenda para reuniões. Necessidade de promoção da educação interprofissional com trabalhadores, bem como de políticas públicas que garantam mecanismos para o trabalho colaborativo na atenção básica.


Resumen Objetivo comparar las actitudes relacionadas con la colaboración interprofesional autoinformada por diferentes equipos de la atención primaria con la realidad observada en sus procesos de trabajo. Método investigación cualitativa y cuantitativa. La recolección de datos ocurrió entre diciembre de 2019 y octubre de 2020. En la etapa cualitativa se utilizó la observación sistemática de la atención en las unidades de salud, con un guión de observación basado en el Referencial de Competencias Interprofesionales y el Diagrama Analizador del Flujo del proceso de trabajo centrado en el usuario. Registramos las observaciones en el diario de campo. En la etapa cuantitativa se aplicó la Escala de Actitudes Relacionadas con la Colaboración Interprofesional. Resultados 91 profesionales respondieron la escala. Se obtuvo una media de 120 puntos, lo que supone valorización del trabajo colaborativo por profesionales de todos los equipos evaluados. Sin embargo, verificamos diferencias entre lo relatado y lo vivido, ya que el proceso de trabajo estructurado parece limitar las actitudes para el trabajo colaborativo. Conclusiones e implicaciones para la práctica valorización de actividades programadas para el trabajo interprofesional de los equipos de salud y de enfermería, como reuniones programadas. Necesidad de promoción de la educación interprofesional, así como de políticas públicas que garanticen mecanismos de trabajo colaborativo.


Abstract Objective to compare self-reported interprofessional attitudes according to the teams from different primary health care services with the actual context of work processes. Method Quantitative and qualitative study in which data were collected in two stages between December of 2019 and October of 2020. Systematic observation was the strategy used to collect data from primary health care centers. A script based on the Canadian Interprofessional Health Collaborative framework and the Analyzer Flowchart was used to observe the patient-centered work process. Observations were recorded in a Field Diary, and the Brazilian version of the Jefferson Scale of Attitudes Toward Interprofessional Collaboration was used. Results 91 primary health workers completed the scale. The median score was 120, meaning all the health teams value collaborative work. Nonetheless, differences were found between what the participants say and what they do, considering that the structured work process limits collaborative practice. Conclusions and Implications to Practice the services need to value programmed activities to promote interprofessional collaboration among health and nursing teams working in primary health care, and reserve time, and give opportunities for meetings to occur. Additionally, training addressing interprofessional collaboration needs to be provided to workers in addition to public policies to ensure mechanisms that promote collaborative practices.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente , Atenção Primária à Saúde , Relações Interprofissionais , Condições de Trabalho , Centros de Saúde , Continuidade da Assistência ao Paciente , Fluxo de Trabalho , Tomada de Decisão Compartilhada
11.
Esc. Anna Nery Rev. Enferm ; 26: e20210070, 2022.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1346054

RESUMO

Resumo Objetivo analisar os estilos e fatores intervenientes na gestão e liderança de enfermeiros em três países, Brasil, Portugal e Espanha, à luz da Burocracia Profissional. Método estudo exploratório e descritivo de abordagem qualitativa realizado em três hospitais universitários localizados em diferentes países: Brasil, Espanha e Portugal. Participaram da pesquisa 30 enfermeiros. Os dados foram coletados por meio de um roteiro de coleta de dados com questões sociodemográficas e entrevistas analisadas com auxílio do software WebQda. Resultados diferentes percepções sobre os elementos integradores da participação foram reveladas nos três países, destacando-se a comunicação em diversas óticas. Verificou-se algumas convergências em relação ao trabalho em equipe, sendo a confiança o elemento que impulsiona e motiva a equipe. Sinaliza-se para uma relação participativa no desenvolvimento do trabalho. Conclusão e implicações para a prática foi possível identificar, nos três países, a importância da comunicação no processo de gestão, bem como dos estilos de gestão e de liderança, como elementos que oportunizam a atuação da equipe. Também foi evidenciada a presença de fatores intervenientes de relevância, tais como escuta, clima organizacional, relação interpessoal, transparência no trabalho e delegação de funções, os quais envolvem a burocracia profissional em que o conhecimento do enfermeiro possibilita o exercício de suas habilidades de forma horizontalizada e participativa.


Resumen Objetivo analizar los estilos y factores implicados en la gestión y el liderazgo de enfermeros en tres países, Brasil, Portugal y España, a la luz de la Burocracia Profesional. Método estudio descriptivo exploratorio con abordaje cualitativo realizado en tres hospitales universitarios ubicados en diferentes países: Brasil, España y Portugal. Treinta enfermeros participaron en la investigación. Los datos fueron recolectados a través de un script de recopilación de datos con preguntas sociodemográficas y entrevistas analizadas con la utilización del software WebQda. Resultados se revelaron diferentes percepciones sobre los elementos integradores de la participación en los tres países, destacando la comunicación desde diferentes perspectivas. Se constataron algunas convergencias en relación al trabajo en equipo, siendo la confianza el elemento que impulsa y motiva al equipo. Se advierte una relación participativa en el desarrollo del trabajo. Conclusión e implicaciones para la práctica se pudo advertir, en los tres países, la importancia de la comunicación en el proceso de gestión, así como los estilos de gestión y liderazgo, como elementos que permiten mejorar el desempeño del equipo. También se evidenciaron factores intervinientes relevantes, como la escucha, el clima organizacional, la relación interpersonal, la transparencia en el trabajo y la delegación de funciones, que conforman la burocracia profesional en la cual el conocimiento de los enfermos les permite el despliegue de sus competencias de manera horizontal y participativa.


Abstract Objective to analyze the styles and factors involved in nurses' management and leadership in three countries, Brazil, Portugal and Spain, in the light of Professional Bureaucracy. Method a descriptive and exploratory study with a qualitative approach carried out in three university hospitals located in different countries, namely: Brazil, Spain and Portugal. Thirty nurses participated in the research. Data was collected through a collection script with sociodemographic questions and interviews analyzed using the WebQda software. Results different perceptions about the integrating elements of participation in the three countries were revealed, highlighting communication from different perspectives. Some convergences in relation to teamwork were verified, where trust was the element that drives and motivates the team. It is a participatory relationship in the development of work. Conclusion and implications for the practice in the three countries, it was possible to identify the importance of communication in the management process, as well as the management and leadership styles, as elements that favor performance of the team. Presence of relevant intervening factors was also evidenced, such as choice, organizational climate, interpersonal relationships, transparency in work and delegation of functions, which involves professional bureaucracy in which the nurses' knowledge allows them to exercise their skills in a horizontal and participatory manner.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Gestão em Saúde , Capacidade de Liderança e Governança , Liderança , Enfermeiras e Enfermeiros , Equipe de Assistência ao Paciente , Portugal/etnologia , Prática Profissional , Qualidade da Assistência à Saúde , Espanha/etnologia , Brasil/etnologia , Autonomia Profissional , Comunicação , Pesquisa Qualitativa , Educação Continuada , Integralidade em Saúde , Relações Interprofissionais
12.
J Med Virol ; 94(1): 119-130, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34403141

RESUMO

This study investigates the effect of the nanostructure of squalene in the form of microemulsion on COVID-19 patients. In this blinded clinical trial, a comparison was made between the efficacy of squalene treatment and controls. A total of 30 COVID-19 patients admitted to the emergency department, and the infection ward was equally allocated to case (n = 15) and control (n = 15) groups according to their age and underlying diseases. The baseline characteristics of subjects, including age, gender, time of treatment onset, underlying condition, white blood cells count, and lymphocyte count were similar (p < 0.05). Baseline laboratory tests and computed tomography (CT) scans were performed for the study groups. The treatment group received 5 mg of intravenous squalene twice a day and standard treatment for 6 days, while controls received only standard treatment. After 6 days of treatment, clinical and CT scan changes were evaluated and compared in intervention and control groups. The need for oxygen therapy (p = 0.020), 2 days of no fever (p = 0.025), cough alleviation (p = 0.010), and lung high-resolution computed tomography improvement (p = 0.033) were significantly different between cases and controls within 7 days of admission. No adverse effects were observed in the treatment group. Our data suggest that squalene could be considered as a potential treatment for COVID-19, and further studies are required to confirm the results.


Assuntos
COVID-19/tratamento farmacológico , Esqualeno/uso terapêutico , Antivirais/administração & dosagem , Antivirais/efeitos adversos , Antivirais/química , Antivirais/uso terapêutico , Emulsões , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Óleos Vegetais/química , Esqualeno/administração & dosagem , Esqualeno/efeitos adversos , Esqualeno/química , Resultado do Tratamento
13.
J Med Virol ; 94(1): 131-140, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34403145

RESUMO

INTRODUCTION: The coronavirus disease 2019 (COVID-19) has quickly become a global threat to public health, and it is difficult to predict severe patients and their prognosis. Here, we intended developing effective models for the late identification of patients at disease progression and outcome. METHODS: A total of 197 patients were included with a 20-day median follow-up time. We first developed a nomogram for disease severity discrimination, then created a prognostic nomogram for severe patients. RESULTS: In total, 40.6% of patients were severe and 59.4% were non-severe. The multivariate logistic analysis indicated that IgG, neutrophil-to-lymphocyte ratio (NLR), lactate dehydrogenase, platelet, albumin, and blood urea nitrogen were significant factors associated with the severity of COVID-19. Using immune response phenotyping based on NLR and IgG level, the logistic model showed patients with the NLRhi IgGhi phenotype are most likely to have severe disease, especially compared to those with the NLRlo IgGlo phenotype. The C-indices of the two discriminative nomograms were 0.86 and 0.87, respectively, which indicated sufficient discriminative power. As for predicting clinical outcomes for severe patients, IgG, NLR, age, lactate dehydrogenase, platelet, monocytes, and procalcitonin were significant predictors. The prognosis of severe patients with the NLRhi IgGhi phenotype was significantly worse than the NLRlo IgGhi group. The two prognostic nomograms also showed good performance in estimating the risk of progression. CONCLUSIONS: The present nomogram models are useful to identify COVID-19 patients with disease progression based on individual characteristics and immune response-related indicators. Patients at high risk for severe illness and poor outcomes from COVID-19 should be managed with intensive supportive care and appropriate therapeutic strategies.


Assuntos
COVID-19/diagnóstico , COVID-19/imunologia , Idoso , COVID-19/fisiopatologia , Progressão da Doença , Feminino , Humanos , Imunoglobulina G/sangue , Contagem de Leucócitos , Linfócitos , Masculino , Pessoa de Meia-Idade , Neutrófilos , Nomogramas , Prognóstico , Estudos Retrospectivos , Índice de Gravidade de Doença
14.
J Med Virol ; 94(1): 141-146, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34406674

RESUMO

Due to the known anti-inflammatory and antiviral effects of zinc, 25(OH)D, and vitamin B12, in this study, we explored the association between serum levels of these micronutrients in coronavirus disease 2019 (COVID-19) patients at the time of admission and the clinical outcomes. This study was carried out on 293 patients with COVID-19, who were hospitalized at Imam Hassan hospital (Bojnourd, Iran). We collected demographic data, clinical characteristics, values of serum biochemical parameters in the first week of admission, and clinical outcomes from electronic medical records. We also measured serum levels of zinc, 25(OH)D, and vitamin B12 within 3 days of admission. Of the 293 hospitalized, the median age was 53 years, and 147 (50.17%) were female. Thirty-seven patients (12.62%) were admitted to the intensive care unit (ICU), and forty-two (14.32%) died. We found that the serum levels of zinc, vitamin B12, and 25(OH)D were lower in patients who died than those who were admitted to ICU or non-ICU and survived; however, these differences were not statistically significant for vitamin B12 and 25(OH)D (p > 0.05). The serum concentrations of zinc, vitamin B12, and 25(OH)D at the time of admission did not affect the length of hospital stay in patients with COVID-19. In general, it seems that serum levels of 25(OH)D, vitamin B12, and especially zinc at the time of admission can affect clinical outcomes in COVID-19 patients.


Assuntos
COVID-19/sangue , COVID-19/fisiopatologia , Vitamina B 12/sangue , Vitamina D/análogos & derivados , Vitamina D/sangue , Zinco/sangue , Adulto , Feminino , Hospitalização , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Prognóstico , Índice de Gravidade de Doença
15.
J Med Virol ; 94(1): 147-153, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34411312

RESUMO

This study aimed to determine the frequency of SARS-CoV-2 RNA in serum and its association with the clinical severity of COVID-19. This retrospective cohort study performed at Toyama University Hospital included consecutive patients with confirmed COVID-19. The prevalence of SARS-CoV-2 RNAemia and the strength of its association with clinical severity variables were examined. Fifty-six patients were included in this study. RNAemia was detected in 19.6% (11/56) patients on admission, and subsequently in 1.0% (1/25), 50.0% (6/12), and 100.0% (4/4) moderate, severe, and critically ill patients, respectively. Patients with RNAemia required more frequent oxygen supplementation (90.0% vs. 13.3%), ICU admission (81.8% vs. 6.7%), and invasive mechanical ventilation (27.3% vs. 0.0%). Among patients with RNAemia, the median viral loads of nasopharyngeal (NP) swabs that were collected around the same time as the serum sample were significantly higher in critically ill (5.4 log10 copies/µl; interquartile range [IQR]: 4.2-6.3) than in moderate-severe cases (2.6 log10 copies/µl; [IQR: 1.1-4.5]; p = 0.030) and were significantly higher in nonsurvivors (6.2 log10 copies/µl [IQR: 6.0-6.5]) than in survivors (3.9 log10 copies/µl [IQR: 1.6-4.6]; p = 0.045). This study demonstrated a relatively high proportion of SARS-CoV-2 RNAemia and an association between RNAemia and clinical severity. Moreover, among the patients with RNAemia, the viral loads of NP swabs were correlated with disease severity and mortality, suggesting the potential utility of combining serum testing with NP tests as a prognostic indicator for COVID-19, with higher quality than each separate test.


Assuntos
COVID-19/virologia , Nasofaringe/virologia , RNA Viral/sangue , SARS-CoV-2/isolamento & purificação , Carga Viral , Viremia , Adolescente , Adulto , Idoso , COVID-19/mortalidade , COVID-19/fisiopatologia , Criança , Estado Terminal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Retrospectivos , Índice de Gravidade de Doença , Adulto Jovem
16.
J Sci Food Agric ; 102(1): 417-424, 2022 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-34143904

RESUMO

BACKGROUND: Thiamethoxam is widely used to control pests in Chinese kale, popularly consumed leafy vegetables. The potential risk to the environment and human health has aroused much public concern. Therefore, it is important to investigate the degradation behavior, residue distribution and dietary risk assessment of thiamethoxam in Chinese kale. RESULTS: A sensitive analytical method for determination of thiamethoxam and its metabolite clothianidin residue in Chinese kale was established and validated through a quick, easy, cheap, effective, rugged, and safe (QuEChERS) technique with ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS). The recoveries were 85.4-101.2% for thiamethoxam and 79.5-108.1% for clothianidin, with the relative standard deviations (RSDs) of 0.9-10.2% and 1.8-6.0%, respectively. For the dissipation kinetics, the data showed that thiamethoxam in Chinese kale was degraded with the half-lives of 4.1 to 4.5 days. In the terminal residue experiments, the residues of thiamethoxam were 0.017-0.357 mg kg-1 after application 2-3 times with a preharvest interval (PHI) of 7 days under the designed dosages. The chronic and acute dietary exposure assessment risk quotient (RQ) values of thiamethoxam in Chinese kale for different Chinese consumers were 0.08-0.19% and 0.05-0.12%, respectively, and those of clothianidin were 0.01-0.04% and 0.02-0.04%, respectively, all of the RQ values were lower than 100%. CONCLUSION: Thiamethoxam in Chinese kale was rapidly degraded following first-order kinetics models. The dietary risk of thiamethoxam and clothianidin through Chinese kale was negligible to consumers. The results from this study are important reference for Chinese governments to developing criteria for the safe and rational use of thiamethoxam, setting maximum residue levels (MRLs), monitoring the quality safety of agricultural products and protecting consumer health. © 2021 Society of Chemical Industry.


Assuntos
Brassica/química , Cromatografia Líquida/métodos , Guanidinas/metabolismo , Neonicotinoides/metabolismo , Resíduos de Praguicidas/química , Resíduos de Praguicidas/metabolismo , Espectrometria de Massas em Tandem/métodos , Tiametoxam/química , Tiametoxam/metabolismo , Tiazóis/metabolismo , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Brassica/metabolismo , Criança , Pré-Escolar , China , Exposição Dietética/efeitos adversos , Exposição Dietética/análise , Feminino , Contaminação de Alimentos/análise , Humanos , Cinética , Masculino , Pessoa de Meia-Idade , Medição de Risco , Verduras/química , Verduras/metabolismo , Adulto Jovem
17.
J Palliat Care ; 37(1): 13-14, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34154461

RESUMO

There are a small number of articles in the literature discussing palliative and end-of-life care in the SMI population. Most tackle the questions relating to competency to refuse care in end-stage anorexia or terminal medical conditions. This is a case review of a 55 year old patient with a complex psychiatric and medical history, who despite extensive treatment and long hospitalizations has failed to regain any ability to care for her basic needs. She has exhausted all available treatment options and her prognosis is extremely poor. The mental health community is resistant to discussing and/ or confronting the fact that such a patient faces with the need for end-of-life care directly related to chronic psychiatric illness.


Assuntos
Cuidados Paliativos na Terminalidade da Vida , Transtornos Mentais , Assistência Terminal , Doença Crônica , Feminino , Humanos , Transtornos Mentais/terapia , Pessoa de Meia-Idade , Cuidados Paliativos
18.
Environ Pollut ; 292(Pt A): 118021, 2022 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-34654571

RESUMO

CONTEXT: Accelerating evidence of endocrine-related morbidity has raised alarm about the ubiquitous use of phthalates in the human environment, but studies have not directly evaluated mortality in relation to these exposures. OBJECTIVES: To evaluate associations of phthalate exposure with mortality, and quantify attributable mortality and lost economic productivity in 2013-4 among 55-64 year olds. DESIGN: This nationally representative cohort study included 5303 adults aged 20 years or older who participated in the US National Health and Nutrition Examination Survey 2001-2010 and provided urine samples for phthalate metabolite measurements. Participants were linked to mortality data from survey date through December 31, 2015. Data analyses were conducted in July 2020. MAIN OUTCOME MEASURES: Mortality from all causes, cardiovascular disease, and cancer. RESULTS: Multivariable models identified increased mortality in relation to high-molecular weight (HMW) phthalate metabolites, especially those of di-2-ethylhexylphthalate (DEHP). Hazard ratios (HR) for continuous HMW and DEHP metabolites were 1.14 (95% CI 1.06-1.23) and 1.10 (95% CI 1.03-1.19), respectively, with consistently higher mortality in the third tertile (1.48, 95% CI 1.19-1.86; and 1.42, 95% CI 1.13-1.78). Cardiovascular mortality was significantly increased in relation to a prominent DEHP metabolite, mono-(2-ethyl-5-oxohexyl)phthalate. Extrapolating to the population of 55-64 year old Americans, we identified 90,761-107,283 attributable deaths and $39.9-47.1 billion in lost economic productivity. CONCLUSIONS: In a nationally representative sample, phthalate exposures were associated with all-cause and cardiovascular mortality, with societal costs approximating $39 billion/year or more. While further studies are needed to corroborate observations and identify mechanisms, regulatory action is urgently needed.


Assuntos
Poluentes Ambientais , Ácidos Ftálicos , Adulto , Estudos de Coortes , Custos e Análise de Custo , Exposição Ambiental , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Inquéritos Nutricionais
19.
Ann Anat ; 239: 151805, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34265386

RESUMO

BACKGROUND: Users of anatomical donors are at risk of exposure to bloodborne pathogens. This study evaluated screening algorithms for hepatitis B and C virus, human immunodeficiency virus and Treponema pallidum during donor allocation and assessed the impact of postmortem time on hemolysis and how hemolysis affects test results and donor discard rate. METHODS: From 2011 to 2018, demographic data of anatomical donors, time of postmortem blood sampling, presence of sample hemolysis, serological test results (negative; active infection; false reactive screening test; historic infection; inconclusive; technically impracticable) and the actual donor allocation were collected. RESULTS: Donors (n = 537) had a mean age of 77.53 ± 13.67 (24-103) year. Nine (1.68%) had laboratory test results indicative for active infection for hepatitis B (n = 1) and C virus (n = 2), human immunodeficiency virus (n = 5) and T. pallidum (n = 1). Negative screenings ranged from 74.67 to 97.58%, depending on the pathogen. According to the original screening algorithms, 479 (89.20%) donors should have been accepted. In practice, a donor acceptance rate of 91.20% was found. Analysis of potential donor allocation interpretation obstacles resulted in simplification of the in-house laboratory testing algorithms and addition of a nucleic acid test to increase the reliability for identification of active (acute) human immunodeficiency virus infection. Hemolysis was more common when sampling was performed more than 24 h after death (p < 0.001). Hemolytic samples more frequently showed a reactive or indeterminate human immunodeficiency virus test result (p < 0.001). Screening for human immunodeficiency virus and T. pallidum was technically more impracticable when hemolysis was present (p = 0.042 and p = 0.003, respectively). Donors with hemolytic blood samples were more often discarded (46.88%) compared to bodies with non-hemolytic samples (6.32%) (p < 0.001). CONCLUSIONS: Despite the implementation of donor screening algorithms, a significant number of bodies have an inconsistent allocation. New algorithms, to be evaluated in future research, were suggested. Early postmortem blood sampling is key as hemolysis can influence certain test results and donor allocation.


Assuntos
Infecções por HIV , Hepatite C , Sífilis , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Doadores de Sangue , Infecções por HIV/diagnóstico , Vírus da Hepatite B , Hepatite C/diagnóstico , Humanos , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos , Estudos Soroepidemiológicos , Sífilis/diagnóstico
20.
Skeletal Radiol ; 51(1): 219-223, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34331550

RESUMO

A 57-year-old patient developed severe, persistent pain following MR arthrography with iodinated contrast. MRI 1 week later showed synovitis which was new compared to the prior MRI. Arthroscopy showed severe synovitis. Histopathology showed synovitis characterized by lymphocytes, neutrophils, and necrosis. One out of 4 intraoperative cultures was positive, but ultimately believed to be due to contaminants. CRP normalized within 1 month. Repeat MRI 2 years later showed progressive degenerative findings, but no evidence of ongoing infection, or stigmata of previous infection. We believe this to be an unusually severe case of reactive synovitis. The purpose of the report is to add to knowledge of reactions to intra-articular contrast injection.


Assuntos
Artrografia , Sinovite , Artroscopia , Meios de Contraste/efeitos adversos , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Sinovite/diagnóstico por imagem
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