RESUMO
In Europe, surveillance indicates that the 2018 West Nile fever transmission season started earlier than in previous years and with a steeper increase of locally-acquired human infections. Between 2014 and 2017, European Union/European Economic Area (EU/EEA) and EU enlargement countries notified five to 25 cases in weeks 25 to 31 compared with 168 cases in 2018. Clinicians and public health authorities should be alerted to ensure timely implementation of prevention measures including blood safety measures.
Assuntos
Culicidae/virologia , Notificação de Doenças/estatística & dados numéricos , Surtos de Doenças , Vigilância da População/métodos , Febre do Nilo Ocidental/diagnóstico , Febre do Nilo Ocidental/transmissão , Vírus do Nilo Ocidental/isolamento & purificação , Animais , Europa (Continente)/epidemiologia , Humanos , Mosquitos Vetores , Estações do Ano , Vigilância de Evento Sentinela , Febre do Nilo Ocidental/epidemiologia , Febre do Nilo Ocidental/virologiaRESUMO
INTRODUCTION: To diagnose and assess chronic respiratory failure in stable chronic obstructive pulmonary disease (COPD) the measurement of arterial blood gases (ABG) is required. It has been suggested that ABG be determined for this purpose when FEV1 ranges between 50% and 30% predicted, but these thresholds are not evidence-based. OBJECTIVE: To identify the post-bronchodilator (BD) FEV1 and arterial oxygen saturation (SaO(2)) values that provide the best sensitivity, specificity, and likelihood ratio (LR) for the diagnosis of hypoxaemic and/or hypercapnic chronic respiratory failure in stable COPD. METHODS: A total of 150 patients were included (39 with PaO2 < 60 mmHg [8 kPa], 14 of them with a PaCO2 ≥ 50 mmHg [6.7 kPa]). The best post-BD FEV(1) and SaO(2) cut-off points to predict chronic respiratory failure were selected using the PC and the Receiver Operating Characteristics (ROC) curves. RESULTS: A post-BD FEV(1) equal to 36% and an SaO(2) of 90% were the best predictive values for hypoxaemic respiratory failure and a post-BD FEV(1) equal to 33% for the hypercapnic variant. An FEV(1) ≥ 45% ruled out hypoxaemic respiratory failure. CONCLUSION: A post-BD FEV(1) of 36% is the best cut-off point to adequately predict both hypoxaemic and hypercapnic respiratory failure in the patient with stable COPD. For its part, an SaO(2) of 90% is the best value for isolated hypoxaemic failure. These values could be considered for future clinical recommendations/guidelines for COPD.