RESUMO
This comprehensive study delves into the epidemiological landscape of Pulmonary Heart Disease (PHD) mortality in the United States from 1999 to 2020, leveraging the extensive CDC WONDER database. PHD encompasses conditions affecting the right side of the heart due to lung disorders or elevated pressure in the pulmonary arteries, including pulmonary hypertension, pulmonary embolism, and chronic thromboembolic pulmonary hypertension (CTEPH). Analyzing data from death certificates, demographic characteristics, and geographical segmentation, significant trends emerge. The age-adjusted mortality rates (AAMRs) for PHD-related deaths show a fluctuating pattern, initially decreasing from 1999 to 2006, followed by a steady increase until 2020. Male patients consistently exhibit higher AAMRs than females, with notable disparities observed among racial/ethnic groups and geographic regions. Non-hispanic (NH) Black or African American individuals, residents of specific states like Colorado and the District of Columbia, and those in the Midwest region demonstrate elevated AAMRs. Furthermore, nonmetropolitan areas consistently manifest higher AAMRs than metropolitan areas. These findings underscore the urgent need for intensified prevention and treatment strategies to address the rising mortality associated with PHD, particularly among vulnerable populations. Insights from this study offer valuable guidance for public health initiatives aimed at reducing PHD-related mortality and improving outcomes nationwide.
Assuntos
Disparidades nos Níveis de Saúde , Doença Cardiopulmonar , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Centers for Disease Control and Prevention, U.S. , Etnicidade/estatística & dados numéricos , Estudos Longitudinais , Doença Cardiopulmonar/epidemiologia , Doença Cardiopulmonar/mortalidade , Grupos Raciais/estatística & dados numéricos , Distribuição por Sexo , Fatores Sexuais , Taxa de Sobrevida/tendências , Estados Unidos/epidemiologia , Negro ou Afro-Americano , Hispânico ou LatinoRESUMO
BACKGROUND: Pneumoconiosis mostly combines pulmonary and cardiovascular diseases, among which pulmonary heart disease (PHD) is of major concern due to its significant impact on the survival of pneumoconiosis patients. White cell count (WCC), red cell distribution width (RDW) and platelet parameters are thought to affect inflammatory responses and may be predictors of various cardiovascular diseases. However, very few studies have focused on PHD. OBJECTIVES: To examine the relationship between baseline complete blood count parameters (WCC, RDW, platelet parameters) and the risk of incident PHD in pneumoconiosis patients. DESIGN: A retrospective cohort study. SETTING: This was a single-centre, retrospective cohort study that used data from an Occupational Disease Hospital, Chengdu, Sichuan. PARTICIPANTS: A total of 946 pneumoconiosis patients from January 2012 to November 2021 were included in the study. Female patients and patients who had PHD, coronary heart disease, hypertensive heart disease, cardiomyopathy, heart failure, oncological disease, multiple organ dysfunction, AIDS at baseline and follow-up time of less than 6 months were also excluded. OUTCOME MEASURES: We identified PHD according to the patient's discharge diagnosis. We constructed Cox proportional hazard regression models to assess the HR of incident PHD in pneumoconiosis, as well as 95% CIs. RESULTS: In the multiple Cox proportional hazard regression analysis, platelet count (PLT) and plateletcrit (PCT) above the median at baseline were associated with an increased risk of PHD in pneumoconiosis with adjusted HR of 1.52 (95% CI 1.09 to 2.12) and 1.42 (95% CI 1.02 to 1.99), respectively. CONCLUSION: Higher baseline PLT and PCT are associated with a higher risk of PHD in pneumoconiosis.
Assuntos
Pneumoconiose , Doença Cardiopulmonar , Humanos , Estudos Retrospectivos , Masculino , Pneumoconiose/sangue , Pneumoconiose/epidemiologia , Feminino , Pessoa de Meia-Idade , China/epidemiologia , Idoso , Contagem de Células Sanguíneas , Doença Cardiopulmonar/sangue , Doença Cardiopulmonar/epidemiologia , Fatores de Risco , Índices de Eritrócitos , Modelos de Riscos Proporcionais , Contagem de Plaquetas , IncidênciaRESUMO
Pulmonary heart disease (PHD) involves altered structure and function of the right ventricle caused by an abnormal respiratory system that causes pulmonary hypertension. However, the association between changes in plasma proteomics and PHD remains unclear. Hence, we aimed to identify causal associations between genetically predicted plasma protein levels and PHD. Mendelian randomization was performed to test the target proteins associated with PHD. Summary statistics for the human plasma proteome and pulmonary heart disease were acquired from the UK Biobank (6038 cases and 426 977 controls) and the FinnGen study (6753 cases and 302 401 controls). Publicly available pQTLs datasets for human plasma proteins were obtained from a largescale genome-wide association study in the INTERVAL study. The results were validated using a case-control cohort. We first enrolled 3622 plasma proteins with conditionally independent genetic variants; three proteins (histo-blood group ABO system transferase, activating signal cointegration 1 complex subunit 1, and calcium/calmodulin-dependent protein kinase I [CAMK1]) were significantly associated with the risk of pulmonary heart disease in the UK Biobank cohort. Only CAMK1 was successfully replicated (odds ratio: 1.1056, 95% confidence interval: 1.019-1.095, p = 0.0029) in the FinnGen population. In addition, the level of CAMK1 in 40 patients with PHD was significantly higher (p = 0.023) than that in the control group. This work proposes that CAMK1 is associated with PHD, underscoring the importance of the calcium signaling pathway in the pathophysiology to improve therapies for PHD.
Assuntos
Estudo de Associação Genômica Ampla , Análise da Randomização Mendeliana , Proteoma , Doença Cardiopulmonar , Humanos , Análise da Randomização Mendeliana/métodos , Estudo de Associação Genômica Ampla/métodos , Masculino , Feminino , Proteoma/metabolismo , Estudos de Casos e Controles , Doença Cardiopulmonar/genética , Doença Cardiopulmonar/sangue , Doença Cardiopulmonar/epidemiologia , Pessoa de Meia-Idade , Reino Unido/epidemiologia , Proteínas Sanguíneas/genética , Proteínas Sanguíneas/metabolismo , Sistema ABO de Grupos Sanguíneos/genética , Idoso , Proteômica/métodos , Adulto , Polimorfismo de Nucleotídeo ÚnicoRESUMO
Resumen Antecedentes: El corazón pulmonar crónico (CPC) muestra un incremento en habitantes que viven en grandes altitudes. Objetivo: Investigar la frecuencia de arritmias cardíacas y factores de riesgo para su desarrollo. Métodos: Estudio descriptivo y transversal; se revisó el registro de pacientes internados del Departamento de Cardiología del Instituto Nacional de Tórax, La Paz, Bolivia, entre enero de 2017 y junio de 2018; se incorporó a todos los individuos con diagnóstico de CPC, definido por criterios clínicos, electrocardiográficos y ecocardiográficos; se incluyó a 162 pacientes que cumplieron los criterios en el análisis; se utilizaron la t de Student y ANOVA. Resultados: Arritmias: fibrilación auricular (FA), 125 (75%); aleteo auricular (AA), 17 (10.5%); taquicardia auricular (TA), 17 (10.5%); extrasístoles, 3 (1.9%). Según el análisis univariado, los factores relacionados con el desarrollo de arritmias fueron: eritrocitosis: FA, RR: 1.33, otras arritmias (RR: 1.67), p = 0.0001; hipertensión arterial pulmonar: FA, RR: 3.10, otras arritmias (RR: 3.21), p = 0.0001; dilatación de aurícula derecha (AD): FA, RR: 1.92, otras arritmias (RR: 2.13), p = 0.0001; obesidad: FA, RR: 3.47, p = 0.001, otras arritmias (RR: 3.70), p = 0.001; hipertensión arterial sistémica: FA, RR: 3.10, p = 0.001, otras arritmias (RR: 3.21), p = 0.001. Según el análisis multivariado: eritrocitosis (RR: 2.2), dilatación de AD (RR: 1.2), p = 0.0001. Conclusiones: Se encontró FA con mayor frecuencia en los pacientes con CPC; los factores de riesgo con mayor significancia estadística para su presentación fueron la eritrocitosis y la dilatación de la AD.
Abstract Background: Chronic cor pulmonale (CPC), with increased presentation in high-altitude inhabitants. Objectives: Investigating the frequency of cardiac arrhythmias, and risk factors for its development. Methods: Descriptive, cross-sectional study, the inpatient registry of the Department of Cardiology of the National Institute of Torax, La Paz-Bolivia, from January 2017 to June 2018 was reviewed, all were incorporated with the diagnosis of CPC, defined by clinical criteria, electrocardiographic and echocardiographic, 162 patients who met the criteria were taken, the student's t-test and ANOVA were used for the analysis. Results: Arrhythmias: atrial fibrillation (AF) 125 (75%), atrial flutter (AA) 17 (10.5%), atrial tachycardia (AT) 17 (10.5%), extrasystoles 3 (1.9%). Univariate analysis of factors related to the development of arrhythmias: erythrocytosis: FA, RR: 1.33, other arrhythmias RR: 1.67, p = 0.0001, pulmonary arterial hypertension: FA, RR: 3.10, other arrhythmias RR: 3.21, p = 0.0001, right atrial dilation (AD): FA, RR: 1.92, other arrhythmias RR: 2.13, p = 0.0001, obesity: FA, RR: 3.47, p = 0.001, other arrhythmias RR: 3.70, p = 0.001, systemic arterial hypertension: FA: RR: 3.10, p = 0.001, other arrhythmias RR: 3.21, p = 0.001. Multivariate analysis: erythrocytosis (RR: 2.2), AD dilation (RR: 1.2), p = 0.0001. Conclusions: AF was found more frequently in patients with CPC, the risk factors with the greatest statistical significance for presentation were: erythrocytosis and AD dilation.
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Arritmias Cardíacas/epidemiologia , Doença Cardiopulmonar/epidemiologia , Altitude , Arritmias Cardíacas/etiologia , Arritmias Cardíacas/fisiopatologia , Policitemia/epidemiologia , Bolívia/epidemiologia , Sistema de Registros , Doença Crônica , Estudos Transversais , Fatores de RiscoRESUMO
Introducción: En el ámbito mundial las enfermedades infecciosas son la segunda causa de muerte en el presente siglo. La epidemiología de las enfermedades infecciosas emergentes y reemergentes plantean desafíos a la clínica y a la salud pública en general, tal es el caso del síndrome cardiopulmonar por hantavirus. Objetivo: Actualizar los conocimientos sobre la vigilancia epidemiológica del microorganismo responsable y documentar a los profesionales de la salud. Métodos: Revisión de artículos de investigación referentes al síndrome cardiopulmonar por hantavirus en el presente siglo. Se realizaron búsquedas en las fuentes de indexación Scopus, SciELO, Medline, Latindex, Bireme, Google. Lilacs, PubMed sobre el microorganismo, patogenia, manifestaciones clínicas, diagnóstico y tratamiento. Conclusiones: La emergencia y reemergencia de este síndrome con alta letalidad debe ser de dominio de clínicos, pediatras, intensivistas, epidemiólogos y los médicos de la atención primaria para su prevención, diagnóstico precoz y conducta oportuna. La vigilancia epidemiológica es fundamental(AU)
Introduction: Infectious diseases are globally the second cause of death in this century. The epidemiology of emerging and reemerging infectious diseases poses clinical and public health challenges in general; such is the home of Hantavirus cardiopulmonary syndrome. Objective: Updating information on the epidemiological surveillance of the causing microorganism and provide said knowledge to health professionals. Methods: Reviewing research articles related to cardiopulmonary syndrome by Hantavirus conducted in the present century. Researches were carried out about the microorganism, pathogenesis, clinical manifestations, diagnosis and treatment in the indexing sources Scopus, SciELO, Medline, Latindex, Bireme, Google, Lilacs and PubMed. Conclusions: The emergence and reemergence of this highly lethal syndrome should be known by clinicians, pediatricians, intensive care staff, epidemiologists and primary care physicians for prevention, early diagnosis and timely treatment. Epidemiological surveillance is essential(AU)
Assuntos
Humanos , Masculino , Feminino , Doença Cardiopulmonar/epidemiologia , Infecções por Hantavirus/complicaçõesRESUMO
El objetivo de este estudio es presentar una estrategia para la práctica de la enseñanza y la evaluación de la semiología cardiopulmonar a través de un examen objetivo clínico estructurado. Las clases prácticas se llevaron a cabo con estudiantes de Medicina. Los estudiantes realizaron anamnesis y examen físico de los pacientes, y posteriormente fue discutido el significado de cada signo y síntoma encontrado. Al final de las clases prácticas se realizó una evaluación práctica basada en el examen objetivo clínico estructurado. Se estableció una situación clínica en la que el estudiante tuvo que realizar la anamnesis, examen físico cardiopulmonar y describir los resultados. Se mostró, por medio de programas de ordenador, sonidos cardiopulmonares de ciertas enfermedades para que el estudiante las identificara. Fue realizada una evaluación de la actividad, a través de un cuestionario aplicado a cada estudiante. La puntuación media de la evaluación práctica fue 8,93. La evaluación de la actividad por los alumnos fue muy positiva, con puntuaciones que van de 3 a 5 en una escala de 0 a 5. La calidad de las clases y las historias clínicas también han sido bien evaluadas, con un promedio de 4. La aplicación de un examen objetivo clínico estructurado en la semiología ha demostrado ser una herramienta útil y eficaz en la evaluación del estudiante de Medicina, junto con las clases prácticas, que hicieron a los estudiantes aptos para reconocer los signos y síntomas principales de enfermedades cardiopulmonares(AU)
The aim of this study is to present a strategy for the teaching practice and evaluation of cardiopulmonary semiology through an objective structured clinical examination. Practical lessons were developed with medical students. The students did anamnesis and physical exams to patients and later, each sign and symptom that was found was analyzed. At the end of practical lessons, a practical evaluation based on the objective structured clinical examination was applied. We have established a clinical situation in which the student had to do anamnesis, physical and cardiopulmonary exam and describe the results. Using computing software, cardiopulmonary sounds present in some diseases were shown to ask the students to identify them. An evaluation of the activity was done by means of a questionnaire applied to each student. Average mark in practical evaluation was 8, 93. The students' evaluation of the activity was very positive, with marks ranging from 3 to 5 in a scale from 0 to 5. Qualities of lessons and clinical histories have also been evaluated with an average mark of 4. The implementation of an objective structured clinical examination in Semiology has proved to be an efficient and useful tool in the evaluation of the medical student together with the practical lessons that made the students apt to recognize main signs and symptoms in cardiopulmonary diseases(AU)
Assuntos
Humanos , Exame Físico/métodos , Doença Cardiopulmonar/epidemiologia , Ensino/educação , Anamnese/métodos , Estudantes de MedicinaRESUMO
El consumo de cigarrillo, según cálculos de la Organización Mundial de la Salud (OMS), es la causa de por lo menos cuatro millones de muertes al año. Las consecuencias de fumar cigarrillo van desde cambios fisiopatológicos en los sistemas respiratorio, cardiovascular y digestivo, hasta trastornos mentales asociados a la dependencia a la nicotina
Assuntos
Humanos , Poluição Ambiental , Neoplasias Pulmonares/diagnóstico , Fumaça , Doença Cardiopulmonar/epidemiologiaRESUMO
El objetivo fue conocer los aspectos clínicos epidemiológicos del Cor Pulmonale Crónico (CPC) en adultos de altura del 2000 al 2006 Hospital Daniel Alcides Huancayo, situado a 3,250 m.s.n.m.. Se empleo un diseño descriptivo observacional analítico retrospectivo, la muestra se determino con criterios de inclusión y exclusión. De 7669 pacientes que fueron hospitalizados se encontró una frecuencia de CPC de 0.5 por ciento (41), promedio de edad: 64.34 más menos 20.87 años (IC:57.96 a 77.1, NS: 0.05 por ciento, rango: 15 a 94). El 75.61 por ciento (31) presentaron mas de 60 años. Las causas comunes fueron fibrosis pulmonar (43.9 por ciento), secuela de TBC pulmonar (26.8 por ciento) y EPOC (21.9 por ciento). Xifoescoliosisse encontró en 100 por ciento de varones. Los antecedentes más importantes fueron Tuberculosis pulmonar y cocinar con leña. La disnea (95.1 por ciento), tos (92.2 por ciento), expectoración (63.1 por ciento), taquipnea (82.9 por ciento), crepitantes y subcrepitantes (70.7 por ciento) y edemas de miembros inferiores (51.2 por ciento) se reportaron en alto porcentaje. La eritrocitosis excesiva en 51.2 por ciento y la ICC en 51.2 por ciento. El promedio de estancia hospitalaria estuvo en los 9.97 más menos 9.0 días. La mortalidad alcanzo el 4.87 por ciento. Se concluye que la CPC tiene baja prevalencia en la población estudiada, la que es más elevada en las mujeres y en mayores de 60 años. La fibrosis pulmonar es la causa más frecuente de CPC.
The Objective was knowing the clinical and epidemiological aspects of Chronic Cor Pulmonale (CPC) in adults of highlands since the 2000 to 2006 in the Hospital Daniel Alcides Carrión de Huancayo, located at 3.250 m.s.n.m. For performing the investigation we used a retrospective analytical observacional descriptive design, the sample was determined with inclusion and exclusion citeria. In the Medicine Department of the Carrion Hospital, of 7669 patients which were hospitalized between 2000 to 2006, the CPC frequency was 0.5 per cent (41), with an average age of 64,34 more less 20,87 years (IC: 57.9 to 77.1, NS: 0.05 per cent, rank of 15 to 94). The 75,61 per cent (31) showed older than 60 years. The most common causes were pulmonary fibrosis (43.9 per cent), pulmonary sequelae of tuberculosis (26.8 per cent) and chronic obstructive pulmonary disease (COPD) (21.9 per cent). The xifoescoliosis was found in 100 per cent of men. The most important antecedent was pulmonary tuberculosis and to cook with firewood. The dyspnea (95.1 per cent), cough (92.2 per cent), expectoration (63.1 per cent), taquipnea (82.9 per cent), pulmonary rales (70.7 per cent, and lower limbs edema (51.2 per cent) were reported in high percentage. Excessive eritrocitosis in 51.2 per cent and Congestive Heart Failure (CHF) in 51.2 per cent Average of hospital stay was 9,97 more less 9,0 days. The mortality reached the 4.87 per cent. The CPC has low prevalence in the studied population, the most frequent in women and people older than 60 years. The pulmonary fibrosis is the main cause of CPC.
Assuntos
Humanos , Masculino , Adolescente , Adulto , Feminino , Pessoa de Meia-Idade , Idoso de 80 Anos ou mais , Altitude , Doença Cardiopulmonar/epidemiologia , Doença Cardiopulmonar/etiologia , Fibrose Pulmonar , Mortalidade , Epidemiologia Descritiva , Estudos Retrospectivos , Estudos TransversaisRESUMO
Objetivou-se investigar as características sociodemográficas e clínicas da clientela assistida em unidade de terapia intensiva de uma instituição publica de referência em doenças cardiopulmonares, em Fortaleza-CE. Foi realizado estudo epidemiológico e retrospectivo. A amostra constituiu-se de 384 prontuários selecionados entre os 1200 de pacientes internados durante o primeiro ano de funcionamento, em 2004. Os resultados apontaram uma população com predominância do sexo masculino, de idosos, aposentados, renda de até um salário mínimo e baixa escolaridade. A maior incidência das causas de internação foi o infarto agudo do miocárdio 166 (43,23 por cento) pacientes; 33,3 por cento fizeram uso de respirador mecânico; 64,3 por cento eram procedentes da emergência; 29 por cento de outras unidades e 6,7 por cento do centro cirúrgico. Constataram-se afecções adquiridas em 90 pacientes, dos quais 60 por cento com infecções respiratórias. Conclui-se que esse perfil epidemiológico pode subsidiar o planejamento da assistência de enfermagem e, conseqüentemente, favorecer a evolução do cliente em tratamento intensivo.
This piece of research has investigated sociodemographic and clinical features of clients assisted at an Intensive Therapy Unit of a major public health institution for cardio-pulmonary diseases in Fortaleza, CE, Brazil. An epidemiological and retrospective study was carried out. The sample consisted of 384 records selected out of those of 1,200 patients taken into that hospital during the first operational year of the unit, in 2004. Results showed that the predominant population is male, old, retired, with income over the minimum wages and low schooling. Heart attacks proved to be the main cause for hospitalization, with 166 (43.23 percent)patients;. 33.3 percent of the patients used mechanical respirators, 64.3 percent came from emergency rooms, 29 percent from other units, and 6.7 percent from the surgical center. Infections were found in 90 patients, 60 percent of which were respiratory in nature. We concluded the epidemiological profile we have delineated can subsidize nursing assistance planning and consequently proves to be relevant to patients evolution under intensive therapy.
Fueran investigadas en esto estudio las características sociodemográficas y clínicas de la clientela atendida en unidad de terapia intensiva de una institución pública de referencia en enfermedades cardiopulmonares, en Fortaleza CE Brasil. Fue cumplido estudio epidemiológico y retrospectivo. La muestra consistió en 384 prontuarios seleccionados entre los 1200 de pacientes internados durante el primer año de funcionamiento, en 2004. Los resultados han señalado que la población predominante en la unidade es del sexo masculino, de ancianos, pensionistas, renta hasta un salario mínimo y baja escolaridad. La incidencia más grande de las causas de internación fue el infarto agudo del miocardio con 166 (43.23 por ciento) de los casos; 33.3 por ciento han utilizado el respirador mecánico; 64.3 por ciento eran procedentes de la emergencia, 29 por ciento de otras unidades y 6.7 por ciento del centro quirúrgico. Fueron encontradas afecciones en 90 pacientes, de los cuales 60 por ciento estaban con infecciones respiratorias. Se concluye que esse perfil epidemiológico puede subvencionar el planeamiento de la asistencia de enfermería y por consecuencia favorecen la evolución del cliente en tratamiento intensivo.
Assuntos
Humanos , Idoso , Cuidados Críticos , Doença Cardiopulmonar/epidemiologia , Hospitalização/estatística & dados numéricos , Pacientes Internados/estatística & dados numéricos , Unidades de Terapia Intensiva , Brasil/epidemiologia , Estudos Retrospectivos , Estudos Transversais , Perfil de Saúde , Prontuários Médicos , Registros de EnfermagemRESUMO
Poco se conoce acerca de la sobrevida de los pacientes que ingresan a nuestras unidades de Paro Cardiorespiratorio (PCR). Realizamos un estudio retrospectivo de pacientes con diagnóstico de PCR en una Unidad de Tratamiento Intensivo Cardiovascular (UTI-CV), durante un periodo de 38 meses, con el fin de determinar las maniobras de reanimación. Entre los factores que tuvieron una influencia significativa se encontraron: el sitio donde ocurría el PCR, la necesidad de intubación traqueal y la recuperación de la conciencia; entre los que no tenían influencia significativa se encontraban: la edad, el sexo, los antecedentes clínicos y la necesidad de drogas vasoactivas. De 50 pacientes que ingresaron a la UTI-CV por PCR, 28 pacientes (56 por ciento) sobrevivieron y fueron dados de alta del hospital; de estos, 9 pacientes (18 por ciento) fallecieron antes de los 6 meses y sólo 19 pacientes (38 por ciento) sobrevivieron, en su mayoría, en buenas condiciones funcionales