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The diagnostic criteria, treatments at the time of admission, and drugs used in patients with acute coronary syndrome are well defined in countless guidelines. However, there is uncertainty about the measures to recommend during patient discharge planning. This document brings together the most recent evidence and the standardized and optimal treatment for patients at the time of discharge from hospitalization for an acute coronary syndrome, for comprehensive and safe care in the patient's transition between care from the acute event to the outpatient care, with the aim of optimizing the recovery of viable myocardium, guaranteeing the most appropriate secondary prevention, reducing the risk of a new coronary event and mortality, as well as the adequate reintegration of patients into daily life.
Los criterios diagnósticos, los tratamientos en el momento de la admisión y los fármacos utilizados en pacientes con síndrome coronario agudo están bien definidos en innumerables guías. Sin embargo, existe incertidumbre acerca de las medidas para recomendar durante la planificación del egreso de los pacientes. Este documento reúne las evidencias más recientes y el tratamiento estandarizado y óptimo para los pacientes al momento del egreso de una hospitalización por un síndrome coronario agudo, para un cuidado integral y seguro en la transición del paciente entre la atención del evento agudo y el cuidado ambulatorio, con el objetivo de optimizar la recuperación de miocardio viable, garantizar la prevención secundaria más adecuada, reducir el riesgo de un nuevo evento coronario y la mortalidad, así como la adecuada reinserción de los pacientes en la vida cotidiana.
Assuntos
Síndrome Coronariana Aguda , Alta do Paciente , Síndrome Coronariana Aguda/terapia , Síndrome Coronariana Aguda/diagnóstico , Humanos , América Latina , Guias de Prática Clínica como AssuntoRESUMO
INTRODUCTION: During the Coronavirus (COVID-19) pandemic, healthcare providers have overcome difficult experiences such as workplace violence. Nurses are particularly vulnerable to workplace violence. The objective of this study was to characterize violence and aggression against nurses during the COVID-19 pandemic in Latin America. METHODS: An electronic cross-sectional survey was conducted in 19 Latin American countries to characterize the frequency and type of violent actions against front-line healthcare providers. RESULTS: Of the original 3544 respondents, 16% were nurses (n = 567). The mean age was 39.7 ± 9.0 years and 79.6% (n = 2821) were women. In total, 69.8% (n = 2474) worked in public hospitals and 81.1% (n = 2874) reported working regularly with COVID-19 patients. Overall, about 68.6% (n = 2431) of nurses experienced at least one episode of workplace aggression during the pandemic. Nurses experienced weekly aggressions more frequently than other healthcare providers (45.5% versus 38.1%, p < .007). Nurses showed a trend of lower reporting rates against the acts of aggression suffered (p = .076). In addition, nurses were more likely to experience negative cognitive symptoms after aggressive acts (33.4% versus 27.8%, p = .028). However, nurses reported considering changing their work tasks less frequently compared to other healthcare providers after an assault event (p = .005). CONCLUSION: Workplace violence has been a frequent problem for all healthcare providers during COVID-19 pandemic in Latin America. Nurses were a particularly vulnerable subgroup, with higher rates of aggressions and cognitive symptoms and lower rate of complaints than other healthcare providers who suffered from workplace violence. It is imperative to develop strategies to protect this vulnerable group from aggressions during their tasks.
Assuntos
COVID-19 , Cardiologia , Violência no Trabalho , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Masculino , Agressão/psicologia , América Latina/epidemiologia , Pandemias , Estudos Transversais , COVID-19/epidemiologia , Violência no Trabalho/psicologia , Local de Trabalho/psicologia , Inquéritos e QuestionáriosRESUMO
Presentamos el caso de una paciente mujer de 31 años con antecedente de litiasis coraliforme bilateral. Ella inició la enfermedad un mes antes del ingreso con trombocitopenia y anemia hemolítica autoinmune. Fue diagnosticada con Síndrome de Evans, inicialmente tuvo marcadores de autoinmunidad negativos, finalmente presentó disnea progresiva y se le encontró 4 masas intracardiacas en aurícula derecha y marcadores positivos para síndrome antifosfolípido. A pesar de la anticoagulación y preparación para cirugía cardiaca, la paciente tuvo una muerte súbita.
We present the case of a 31-year-old female patient with a history of bilateral staghorn lithiasis, who started the disease one month before admission with thrombocytopenia and autoimmune hemolytic anemia. She was diagnosed with Evans Syndrome, initially she had negative autoimmunity markers, finally presented progressive dyspnea and 4 intracardiac masses were found in the right atrium and positive markers for antiphospholipid syndrome. Despite anticoagulation and preparation for cardiac surgery, she presented sudden death.
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COVID-19 pandemic and lockdown measures have disrupted lifestyle habits and self-care. Gender differences in health behavior during the pandemic have not yet been fully elucidated. The aim of this study was to evaluate gender related differences in the impact of COVID-19 pandemic on patients with cardiometabolic diseases. A cross-sectional survey was administered to cardiometabolic patients in 13 Latin American countries between June 15th and July 15th, 2020. The study included 4216 participants, of which 2147 (50.9%) were women. Women reported healthier eating habits as well as lower tobacco and alcohol consumption than men but exercised less and reported increased symptoms of depression. Low income and symptoms of depression were associated with sedentarism in women. The interplay between psychological factors and sedentarism could increase the risk of cardiovascular events in this population.
Assuntos
COVID-19 , Doenças Cardiovasculares , Doenças Cardiovasculares/epidemiologia , Controle de Doenças Transmissíveis , Estudos Transversais , Feminino , Humanos , América Latina/epidemiologia , Masculino , Pandemias , SARS-CoV-2 , Fatores SexuaisRESUMO
Sudden cardiac death (SCD) is responsible for approximately 6% of global mortality and 25% of cardiovascular (CV) deaths. SCD has been traditionally linked to coronary artery disease, valvular heart disease, cardiomyopathies, and genetic arrhythmia disorders. However, advancements in care for these diseases have not translated to a proportional reduction in SCD. This suggests an important role of underrecognized contributing pathologies. Neglected tropical diseases (NTDs) are a group of illnesses prevalent in tropical and sub-tropical regions which have been understudied partially due to their high prevalence in marginalized populations. The relationship between SCD and Chagas disease has been well-established, though emerging literature suggests that other NTDs with CV involvement may lead to fatal arrhythmias. Additionally, specific therapies for a subset of NTDs put patients at increased risk of malignant arrhythmias and other cardiac complications. This review aims to summarize the association between a group of selected NTDs and SCD.
RESUMO
BACKGROUND: The first case of coronavirus 2019 (COVID-19) in Latin America was detected on February 26th, 2020, in Brazil. Later, in June, the World Health Organization announced that the focus of the outbreak had shifted to Latin America, where countries already had poor control of indicators of noncommunicable diseases (NCDs). Concerns about coronavirus infection led to a reduced number of visits and hospitalizations in patients with NCDs, such as cardiovascular disease, diabetes, and cancer. There is a need to determine the impact of the COVID-19 pandemic on patients who have cardiometabolic diseases but do not have clinical evidence of COVID-19 infection. METHODS: The CorCOVID LATAM is a cross-sectional survey of ambulatory cardiometabolic patients with no history or evidence of COVID-19 infection. The study will be conducted by the Interamerican Society of Cardiology. An online survey composed of 38 questions using Google Forms will be distributed to patients of 13 Latin American Spanish-speaking countries from June 15th to July 15th, 2020. Data will be analyzed by country and regions. Seven clusters of questions will be analyzed: demographics, socioeconomic and educational level, cardiometabolic profile, lifestyle and habits, body-weight perception, medical follow-up and treatments, and psychological symptoms. RESULTS: Final results will be available upon completion of the study. CONCLUSIONS: The present study will provide answers regarding the impact of the COVID-19 pandemic on noninfected cardiometabolic patients. Data on this topic are scarce, as it is an unprecedented threat, without short-term solutions.
CONTEXTE: Le premier cas de maladie à coronavirus 2019 (COVID-19) en Amérique latine a été détecté le 26 février 2020 au Brésil. En juin, l'Organisation mondiale de la Santé a annoncé que le foyer de l'épidémie s'était déplacé en Amérique latine, où le suivi des indicateurs relatifs aux maladies non transmissibles est déjà déficient. Les préoccupations relatives à l'infection par le coronavirus ont entraîné une diminution du nombre de consultations et d'hospitalisations des patients atteints d'une maladie non transmissible, comme une ma-ladie cardiovasculaire, le diabète ou un cancer. Il est donc nécessaire d'évaluer l'incidence de la pandémie de COVID-19 chez les patients atteints d'une maladie cardiométabolique ne présentant aucun signe clinique d'une infection au virus de la COVID-19. MÉTHODOLOGIE: L'étude CorCOVID LATAM est une enquête transversale menée auprès des patients ambulatoires atteints d'une maladie cardiométabolique n'ayant pas d'antécédents d'infection au virus de la COVID-19 et ne présentant aucun signe d'une telle infection. L'étude est réalisée par la Société interaméricaine de cardiologie. Du 15 juin au 15 juillet 2020, on a demandé aux patients de 13 pays hispanophones d'Amérique latine de répondre à un questionnaire en ligne de 38 questions dans Google Forms. Les données seront analysées par pays et par région. Les réponses aux questions seront examinées selon sept grands thèmes : caractéristiques démographiques, caractéristiques socioéconomiques et niveau de scolarité, profil cardiométabolique, mode de vie et habitudes, perception quant au poids corporel, suivi et traitements médicaux et symptômes psychologiques. RÉSULTATS: Les résultats seront publiés à la fin de l'étude. CONCLUSIONS: L'étude fournira des renseignements sur l'incidence de la pandémie de COVID-19 chez les patients atteints d'une maladie cardiométabolique non infectés. Les données sur cette question sont rares, puisqu'il s'agit d'une menace sans précédent, à laquelle il n'existe de surcroît pas de solution à court terme.
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Determinar el nivel de riesgo coronario global a los 10 años en trabajadores de operaciones oleoducto de Petroperú, desde marzo a mayo del 2012. Métodos: El estudio es de tipo transversal, descriptivo, y observacional. Se revisaron las historias ocupacionales de 113 trabajadores. Se evaluó el Riesgo Coronario Global (RCG) a 10 años mediante la Tabla de Framingham que incluye las siguientes características: edad, sexo, Presión arterial sistólica (PAS), colesterol total y HDL, tabaquismo, Diabetes Mellitus (DM) e Hipertrofia Ventricular Izquierda (HVI). Se llenó una ficha de recolección de datos, elaborada en base a los objetivos planteados, con la información obtenida a partir de las historias ocupacionales y de los resultados de los Exámenes Médicos Periódicos. Se generó una base de datos y se efectuó el análisis con Microsoft Office - Exce12010. Resultados y Conclusiones: La mayoría de trabajadores son de edad avanzada (promedio >55años), con una PAS promedio dentro de los normal, con resultados de colesterol total promedio en límite de lo normal alto y con un HDL promedio bajo. Además se observa una prevalencia de Tabaquismo de 15.04% y de Diabetes Mellitus de 15.93%. El promedio de RCG fue de 12.21 %, lo que significaría: que de 100 trabajadores, 12 sufrirán un evento Coronario en los próximos 10 años. Más de la mitad de los trabajadores presentan un Riesgo Medio de sufrir un evento Coronario en los próximos 10 años. Un Riesgo Alto se encontró en alrededor del 5% de los trabajadores...
Determine the level of overall coronary risk in workers 10 years of pipeline operations Petroperú from March to May 2012. Methods: The study is transversal, descriptive and observational. We reviewed the occupational histories of 113 workers. Coronary risk was evaluated Global (RCG) to 10 years by the Framingham chart that includes the following characteristics: age, sex, systolic blood pressure (SBP), total cholesterol and HDL, smoking, diabetes mellitus (DM) and Left Ventricular Hypertrophy (LVH). It filled a data collection sheet, prepared on the basis of the stated objectives, with information obtained from occupational histories and the results of periodic medical examinations. Generated a database and analysis was performed with Microsoft Office - Exce1201O. Results and conclusions: Most workers are elderly (average> 55años), with an average SBP within the normal, average total cholesterol results in high normal limit and a low average HDL. In addition there is a smoking prevalence of 15.04% and 15.93% Diabetes Mellitus. The RCG average was 12.21 %, which would mean: that of 100 workers, 12 will suffer a coronary event over the next 10 years. More than half of workers are at medium risk of suffering a coronary event over the next 10 years. A High Risk was found in about 5% of the workers...