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1.
Infectio ; 25(4): 262-269, oct.-dic. 2021. tab, graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1286720

RESUMO

Abstract Objective: To analyse the clinic characteristics, risk factors and evolution of the first cohort of hospitalised patients with confirmed infection by COVID-19 in 5 Colombian institutions. Materials and methods: Is a retrospective observational study of consecutive hospitalized patients with a diagnosis of COVID-19 confirmed from March 01 to May 30, 2020 in Colombia. Results: A total of 44 patients were included. The median age was 62 years. 43.2% had a history of smoking, while 69.8% were overweight or obese. 88.6% had at least one comorbidity and 52.3% had three or more comorbidities. Hypertension and dyslipidaemia were the most frequent comorbidities (40.9% and 34.1%, respectively). The 30-day mortality rate was 47.7% with a median of 11 days. The composite outcome occurred in the 36.4%. The biomarkers associated with mor tality risk included troponin higher than 14 ng/L (RR: 5.25; 95% CI 1.37-20.1, p = 0.004) and D-dimer higher than 1000 ng/ml (RR: 3.0; 95% CI 1.4-6.3, p = 0.008). Conclusions: The clinical course of SARS-CoV-2 infection in hospitalized Colombian was characterised by a more advanced stage of the infection.


Resumen Objetivo: Analizar las características, clínicas, factores de riesgo, y la evolución de pacientes hospitalizados con infección confirmada por COVID-19 en 5 Institu ciones de Colombia. Material y método: Es un estudio observacional retrospectivo de pacientes consecutivos hospitalizados con diagnóstico de COVID-19 confirmado entre 01 de Febrero de 2020 y 30 de Mayo de 2020 en Colombia. Resultados: Un total de 44 pacientes fueron incluidos. La mediana de edad fue de 62 años y la mayoría del sexo masculino. El 43.2% tenían historia de tabaquismo, mientras que el 69.8% tenían sobrepeso u obesidad. El 88.6% tenían al menos una comorbilidad y el 52.3% tenían tres o más comorbilidades. La hipertensión arterial fue la comorbilidad más frecuente (40.9%), seguido de la dislipidemia (34.1%). La tasa de letalidad a 30 días fue de 47.7% y ocurrió con una mediana de 11 días. El 36.4% presentó el desenlace compuesto. Los biomarcadores asociados con el riesgo de muerte fue troponina > 14 ng/mL (RR:5.25, IC95% 1.37-20.1, p=0.004) y dímero D mayor a 1000 mg/dL (RR: 3.0, IC95% 1.4-6.3, p=0.008). Conclusiones: El curso clínico de la infección por SARS-CoV-2 en colombianos hospitalizados fue un estadio más avanzado de la infección.


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Biomarcadores , COVID-19 , Pacientes , Tabagismo , Comorbidade , Risco , Fatores de Risco , Mortalidade , Colômbia , Sobrepeso , Cursos , Infecções , Obesidade
2.
Infectio ; 25(4): 256-261, oct.-dic. 2021. tab, graf
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286719

RESUMO

Resumen Objetivo: Determinar los factores de riesgo en adultos con COVID-19 en población rural andina durante 2020. Métodos: En este estudio de cohorte retrospectivo multicéntrico, incluimos a 184 pacientes adultos (≥18 años) con pruebas serológicas y moleculares para CO VID-19 de tres hospitales de la sierra peruana (Ancash y Apurímac) incluidos con sospecha clínica entre abril y junio. Se utilizó análisis descriptivos y regresión logística univariable para explorar los factores de riesgo asociados a los pacientes con COVID-19. Resultados: Del total de pacientes, 14 (7.6%) tuvieron SARS-CoV-2. En los pacientes infectados 12 (85.7%) fueron varones con promedio de edad de 47.3±21 años. Las comorbilidades estuvieron presentes en cerca de la tercera parte de pacientes, siendo la hipertensión y diabetes las más frecuentes (ambas 14.3%), y la sinto matología más frecuentes fueron fiebre y cefalea (57.2%). La regresión univariable mostró mayores probabilidades de infección con SARS-CoV-2 en la población rural andina asociada con la edad avanzada (OR: 1.1 IC95% 0.7-1.8; p=0,019), comorbilidades previas (OR: 1.7, IC95% 0.32-9.39; p=0,006), y sintomatología previa (OR: 49.8, IC95% 5.6-436.9; p=0,0011). Conclusiones: Los posibles factores de riesgo como la edad avanzada, las comorbilidades y sintomatología previas están relacionados con el desarrollo de CO VID-19 en población rural andina de Perú.


Abstract Objective: To determine the risk factors in adults with COVID-19 in the rural Andean population during 2020. Methods: This multicenter retrospective cohort study included 184 adult patients (≥18 years) with COVID-19's serological and molecular tests from three Hospitals in the Peruvian mountains (Ancash and Apurímac) included with clinical suspicion between April and June. Descriptive analysis and univariate logistic regression were used to explore the risk factors associated with patients with COVID-19. Results: Of total of patients, 14 (7.6%) had a SARS-CoV-2. In infected patients 12 (85.7%) were men with an average age of 47.3±21 years. Comorbidities were present in about a third of patients, with hypertension and diabetes being the most frequent (both 14.3%), and the most frequent symptoms were fever and hea dache (57.2%). Univariate regression showed higher probabilities of infection with SARS-CoV-2 in the rural Andean population associated with advanced age (OR: 1.1 95% CI 0.7 - 1.8; p = 0.019), previous comorbidities (OR: 1.7, 95%CI 0.32 - 9.39; p = 0.006), and previous symptoms (OR: 49.8, 95%CI 5.6 - 436.9; p = 0.0011). Conclusions: Possible risk factors such as advanced age, comorbidities and previous symptoms are related to the development of COVID-19 in the rural Andean population of Peru.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , COVID-19 , Peru , População Rural , Fatores de Risco , Estudos de Coortes , SARS-CoV-2 , Cefaleia , Hospitais , Hipertensão , Infecções
3.
Infectio ; 25(4): 212-240, oct.-dic. 2021. tab, graf
Artigo em Inglês | LILACS, COLNAL | ID: biblio-1286716

RESUMO

Abstract Intra-abdominal infections are frequent at all levels of health care, therefore, it is necessary to maintain a high level of clinical suspicion, performing the fastest and most cost-effective measures to confirm the diagnosis and offer a precise and targeted multidisciplinary therapy, this being the only way to have an impact on the morbidity of this infection, reducing mortality and minimizing the complications and costs of health care. Intra-abdominal infections are linked to the appearance and selection of resistant mutants in both bacteria and fungi, becoming currently a major public health problem. Increasing bacterial resistance when associated with a greater possibility of difficulties in antimicrobial treatment increases mortality. This evidence-based consensus brings together the recommendations for the diagnosis and treatment of intra-abdominal infections in the pediatric and adult population. With strict monitoring of bacterial resistance and stimulating the control of the risk factors that have the greatest impact on the appearance of this phenomenon, this consensus is intended to be a practical guide that is easy to implement, and with periodic updates it will favor and facilitate multidisciplinary and the adequacy of the therapeutic management of intra-abdominal infections.


Resumen Las infecciones intrabdominales son frecuentes en todos los niveles de atención en salud, por ende, es necesario mantener un alto nivel de sospecha clínica, realizando las medidas más rápidas y costoefectivas para confirmar el diagnóstico y así ofrecer de una forma precisa y dirigida la terapéutica multidisciplinaria, siendo esta la única manera de tener impacto en la morbilidad de esta infección, disminuyendo la mortalidad y minimizando las complicaciones y los costos de la atención en salud. Las infecciones intrabdominales se encuentran ligadas a la aparición y selección de las mutantes resistentes tanto en las bacterias como en los hongos, convirtiéndose en la actualidad en una gran problemática en la salud pública. La creciente resistencia bacteriana al asociarse a mayor posibilidad de dificultades en el tratamiento antimicrobiano incrementa la mortalidad. Este consenso basado en la evidencia, reúne las recomendaciones en el diagnóstico y en el tratamiento de las infecciones intrabdominales en la población pediátrica y de adultos. Con un estricto seguimiento de la resistencia bacteriana y estimulando el control de los factores de riesgo que tienen mas impacto en la aparición de este fenómeno, este consenso pretende ser una practica guía de fácil implementación, y con periódicas actualizaciones favorecerá y facilitará el manejo multidisciplinario y la adecuación del manejo terapéutico de las infecciones intrabdominales.


Assuntos
Humanos , Criança , Adulto , Infecções Intra-Abdominais , Peritonite , Bactérias , Fatores de Risco , Mortalidade , Colômbia , Sepse , Atenção à Saúde , Infecções , Antibacterianos
4.
Infectio ; 25(4): 284-288, oct.-dic. 2021. tab
Artigo em Espanhol | LILACS, COLNAL | ID: biblio-1286723

RESUMO

Resumen Objetivo: Determinar los factores de riesgo a la infección en cavidad residual post quistectomía hepática en los pacientes del hospital Ramiro Prialé Prialé - EsSalud -Huancayo. Materiales y Métodos: Se realizó una cohorte retrospectiva, entre enero del 2014 y enero del 2018. Se utilizó una ficha de recolección de datos. Se obtuvieron los riesgos relativos (RR) crudos y ajustados, con intervalos de confianza al 95%. Resultados: Participaron 83 pacientes. El 41,2% de las mujeres presentaron infección en la cavidad postquistectomía y la mediana de edad de los pacientes infecta dos fue de 33 años. Los antecedentes patológicos que se relacionaron con la infección fueron obesidad o sobrepeso (62,5%), neoplasia previa (100%) y enferme dad inmunológica previa (31%). La infección en cavidad residual postquistectomía estuvo relacionada a la presencia de obesidad o sobrepeso, diabetes mellitus, neoplasia previa , cirugía previa y al uso de antibióticos posteriores a la cirugía. Conclusiones: La obesidad o sobrepeso, diabetes mellitus, haber padecido alguna neoplasia o cirugía previa y el uso de antibióticos luego de la cirugía; son factores de riesgo para la infección en cavidad residual postquistectomía hepática en los pacientes del Hospital Nacional Ramiro Prialé Prialé EsSalud de Huancayo, Perú.


Abstract Objective: To determine the risk factors with the infection in the residual cavity after hepatic cystectomy in the patients of the Ramiro Prialé Prialé hospital - EsSalud -Huancayo. Materials and Methods: A retrospective cohort was conducted, between January 2014 and January 2018. A data collection sheet was used. Crude and adjusted relative risks (RR) were obtained, with 95% confidence intervals. Results: 83 patients participated. 41.2% of women infected in the post-cystectomy cavity and the median age of infected patients was 33 years. The pathological antecedents that were related to the infection were obesity or overweight (62.5%), previous neoplasia (100%) and previous immune disease (31%). Post-cystectomy residual cavity infection was affected by the presence of obesity or overweight (aRR: 1.56; 95% CI: 1.15-2.13; p value = 0.005), diabetes mellitus (aRR: 2.67; 95% CI : 2.09-3.41; p value <0.001), previous neoplasia (aRR: 2.49; 95% CI: 1.94-3.20; p value <0.001), previous surgery (aRR: 1.49; 95% CI: 1.36-1.64; p value <0.001) and the use of post-surgery antibiotics (aRR: 2.14; 95% CI: 1.30-3.51; p value = 0.003) Conclusions: Obesity or overweight, diabetes mellitus, having suffered some neoplasia or previous surgery and the use of antibiotics after surgery; they are factors associated with infection in the residual post-cystectomy liver cavity in patients of the Ramiro Prialé Prialé EsSalud National Hospital in Huancayo, Peru.


Assuntos
Humanos , Feminino , Adulto , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Fatores de Risco , Infecções , Peru , Ranunculaceae , Diabetes Mellitus , Equinococose Hepática , Hospitais , Doenças do Sistema Imunitário , Neoplasias
5.
Rev. enferm. UERJ ; 29: e56924, jan.-dez. 2021.
Artigo em Inglês, Português | LILACS | ID: biblio-1224444

RESUMO

Objetivo: descrever a incidência de complicações em feridas operatórias de mastectomia e identificar fatores associados. Método: estudo retrospectivo desenvolvido em uma coorte hospitalar de 545 mulheres mastectomizadas por câncer de mama no ano 2018 em um centro de assistência de alta complexidade em oncologia da cidade do Rio de Janeiro, Brasil, após aprovação por Comitê de Ética em Pesquisa. Os dados foram coletados a partir dos prontuários, permitindo cálculos da taxa de incidência e da razão da taxa de incidência para cada complicação. Resultados: a complicação que apresentou maior taxa de incidência foi o sangramento (57,14/100 mastectomias-dia), tendo como fatores associados a raça/cor da pele não branca (Razão da Taxa de Incidência: 3,11) e a diabetes mellitus (Razão da Taxa de Incidência: 0,48). Conclusão: os fatores associados ao sangramento da ferida operatória apontam para a necessidade de novas práticas no cuidado ao pós-operatório de mulheres mastectomizadas.


Objective: to describe the incidence of complications in mastectomy surgical wounds and to identify associated factors. Method: this retrospective study was conducted in a hospital cohort of 545 women mastectomized for breast cancer in 2018 at a high-complexity cancer care center Rio de Janeiro City, Brazil, after approval by the research ethics committee. Data were collected from medical records, allowing incidence rate and incidence rate ratio to be calculated for each complication. Results: the complication with the highest incidence rate was bleeding (57.14/100 mastectomies-day), associated factors being non-white race/skin color (incidence rate ratio 3.11) and diabetes mellitus (incidence rate ratio 0.48). Conclusion: the factors associated with bleeding from the surgical wound point to the need for new practices in post-operative care for women with mastectomies.


Objetivo: describir la incidencia de complicaciones en heridas quirúrgicas de mastectomía e identificar factores asociados. Método: estudio retrospectivo desarrollado en una cohorte hospitalaria de 545 mujeres mastectomizadas por cáncer de mama en 2018 en un centro de atención de alta complejidad en oncología de la ciudad de Río de Janeiro, Brasil, previa aprobación del Comité de Ética en Investigación. Los datos se obtuvieron de las historias clínicas, lo que permitió calcular la tasa de incidencia y el cociente de la tasa de incidencia para cada complicación. Resultados: la complicación que presentó mayor tasa de incidencia fue el sangrado (57,14 / 100 mastectomías-día), con factores asociados a la raza / color de piel no blanca (índice de tasa de incidencia: 3,11) y diabetes mellitus (índice de tasa de incidencia: 0,48). Conclusión: los factores asociados al sangrado de la herida quirúrgica apuntan a la necesidad de nuevas prácticas en el cuidado al postoperatorio de las mujeres con mastectomía.


Assuntos
Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Complicações Pós-Operatórias/epidemiologia , Ferida Cirúrgica/complicações , Mastectomia/efeitos adversos , Brasil/epidemiologia , Neoplasias da Mama/cirurgia , Incidência , Estudos Retrospectivos , Fatores de Risco , Hemorragia Pós-Operatória/epidemiologia
6.
Estima (Online) ; 19(1): e1021, jan.-dez. 2021.
Artigo em Português | BDENF - enfermagem (Brasil) | ID: biblio-1280950

RESUMO

Objetivo:identificar e descrever os fatores de risco para desenvolvimento de lesão por pressão em pacientes oncológicos adultos e as intervenções preventivas interdisciplinares. Método: revisão integrativa da literatura. A coleta de dados foi realizada no período de março e abril de 2019 e dezembro de 2020, utilizando as bases de dados: BDENF; PubMed/Medline; Embase; Scopus; Cinahal e Web of Science. Resultados: a amostra foi composta por 16 artigos publicados no período de 2008 a 2019. Dentre os fatores de risco identificados destacam-se: situação nutricional, idade avançada, incontinência e imobilidade; as intervenções preventivas interdisciplinares identificadas foram: mudança de decúbito, avaliação e acompanhamento nutricional, cuidados com a pele e uso de superfícies de suporte. Conclusão: há necessidade de mais estudos para um olhar cuidadoso e assertivo para os pacientes oncológicos.


Objective:identify and describe the risk factors for the development of pressure injuries in adult cancer patients and interdisciplinary preventive interventions. Method: integrative literature review. Data collection was carried out between March and April 2019 and December 2020, using the databases: BDENF; PubMed/Medline; Embase; Scopus; Cinahal and Web of Science. Results: the sample consisted of 16 articles published from 2008 to 2019. Among the risk factors identified, the following stand out: nutritional status, advanced age, incontinence and immobility; the interdisciplinary preventive interventions identified were: decubitus change, nutritional assessment and monitoring, skin care and use of support surfaces. Conclusion: further studies are needed to take a careful and assertive look at cancer patients.


Assuntos
Equipe de Assistência ao Paciente , Fatores de Risco , Lesão por Pressão , Oncologia
7.
Estima (Online) ; 19(1): e1121, jan.-dez. 2021.
Artigo em Português | BDENF - enfermagem (Brasil) | ID: biblio-1280951

RESUMO

Objetivos:identificar a incidência e caracterizar as lesões por pressão em unidade de terapia intensiva adulta quanto à ocorrência, locais e fatores de risco, e verificar se há associação entre esses e o surgimento das lesões. Método: estudo observacional, coorte, prospectivo, desenvolvido em unidade de terapia intensiva de hospital terciário, de outubro a dezembro de 2019. A população constitui-se de adultos em primeiro dia de internação na unidade, sem lesão por pressão na admissão. Os participantes foram acompanhados durante a internação e variáveis sociodemográficas e clínicas, assim como avaliação do risco de desenvolver lesão por pressão, avaliação da pele e escala de Braden foram coletadas diariamente. Empregaram-se testes de Qui-quadrado de Pearsone teste t de student para avaliar as relações entre variáveis e lesões. Para as análises foi considerado nível de significância (α) de 5%. Resultados: foram incluídos 40 participantes, 20% apresentaram lesão por pressão com predominância dos estágios 1 e 2; os principais locais afetados foram a região sacral seguida pelo calcâneo. O tempo médio de internação foi 23,38 dias para o grupo com lesão e 5,77 dias para o grupo sem lesão; o tempo apresentou relação significativa com o surgimento das lesões (p=0,002). Conclusão: conclui-se que o local mais acometido foi a região sacral e grau 1 o estadiamento mais frequente; o tempo de internação foi a variável que influenciou o surgimento de lesões.


Objectives:identify the incidence and characterize pressure injuries in an adult intensive care unit regarding the occurrence, locations and risk factors, and verify whether there is an association between these and the appearance of the injuries. Method: observational, cohort, prospective study, developed in an intensive care unit of a tertiary hospital, from October to December 2019. The population consists of adults on the first day of admission to the unit, without pressure injury at admission. Participants were monitored during hospitalization, sociodemographic and clinical variables, and risk assessment of developing a pressure injury, skin assessment and Braden scale were collected daily. Pearson's chi-square tests and student's t-test were used to assessing the relationship between variables and injuries. For the analyzes, a significance level (α) of 5% was considered. Results:40 participants were included, 20% had pressure injuries with a predominance of stages 1 and 2; the main affected sites were the sacral region followed by the calcaneus. The average hospital stay was 23.38 days for the injured group and 5.77 days for the non-injured group; time showed a significant relationship with the appearance of lesions (p = 0.002). Conclusion: it was concluded that the most affected site was the sacral region and grade 1 was the most frequent staging; length of stay was the variable that influenced the appearance of injuries.


Assuntos
Incidência , Fatores de Risco , Enfermagem , Lesão por Pressão , Unidades de Terapia Intensiva
8.
Nutr J ; 20(1): 82, 2021 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-34602077

RESUMO

BACKGROUND: To investigate the causal association between serum 25-hydroxyvitamin D (25OHD), calcium (Ca), and parathyroid hormone (PTH) levels and the risk of coronary artery disease (CAD) in patients with diabetes using a Mendelian randomization approach. METHODS: Genetic signatures associated with serum 25OHD, Ca, and PTH levels were extracted from recently published genome-wide association study (GWAS), including 79,366, 39,400, 29,155 individuals, respectively. Genetic association estimates for CAD in patients with diabetes were obtained from a GWAS of 15,666 individuals with diabetes (3,968 CAD cases, 11,696 controls). The inverse-variance-weighted method was employed for the primary analysis, and other robust methods were applied for sensitivity analyses. RESULTS: Six, seven and five single nucleotide polymorphisms were identified as instrumental variables for serum 25OHD, Ca and PTH levels, respectively. There was no significant association between genetically predicted serum 25OHD levels and the risk of CAD in patients with diabetes (odds ratio (OR) = 1.04, 95% confidence interval (CI): 0.58 - 1.87, P = 0.888). Similarly, genetically predicted serum Ca (OR = 1.83, 95% CI: 0.62 - 5.35, P = 0.273) and PTH levels (OR = 1.27, 95% CI: 0.67 - 2.44, P = 0.464) were not significantly associated with the risk of CAD in patients with diabetes. These findings were robust in sensitivity analyses. CONCLUSIONS/INTERPRETATION: Serum 25OHD, Ca and PTH levels may not be causally associated with the risk of CAD in patients with diabetes.


Assuntos
Doença da Artéria Coronariana , Diabetes Mellitus , Cálcio , Doença da Artéria Coronariana/genética , Estudo de Associação Genômica Ampla , Humanos , Análise da Randomização Mendeliana , Hormônio Paratireóideo , Fatores de Risco , Vitamina D/análogos & derivados
9.
Nutr J ; 20(1): 83, 2021 10 03.
Artigo em Inglês | MEDLINE | ID: mdl-34602079

RESUMO

BACKGROUND: A growing number of researches supported that dietary fructose was associated with most of the key features of metabolic syndrome (MetS). However, there was no related epidemiological studies among Chinese population, despite the sharp increase in MetS cases. This study explores the relationship between dietary fructose and MetS among Chinese residents aged 45 and above. METHODS: A total of 25,528 participants (11,574 males and 13,954 females) were included in this nationwide representative cross-sectional study of China National Nutrition and Health Survey. Dietary fructose intake was assessed by 3-day 24-h dietary records. MetS was defined by the International Diabetes Federation and Chinese Diabetes Society criteria. RESULTS: The consumption of dietary fructose was 11.6 g/day for urban residents and 7.6 g/day for rural residents. Fruits and vegetables as well as their products were the main sources of fructose intake. There was no association between dietary fructose intake and the odds of having MetS in both urban (P = 0.315) and rural residents (P = 0.230) after adjustment for confounding factors. Moreover, for urban residents participating physical activities, the odds of having MetS in the fourth quartiles (OR: 0.67; 95%CI: 0.52-0.87) was lower than that in the first quartile. In the sensitivity analysis, a significant reduction in the odds of having MetS was also found in the fourth quartiles (OR, 95%CI: 0.68, 0.51-0.90; 0.67, 0.49-0.91; 0.74, 0.56-0.99) compared with the first quartile when excluding smokers, alcohol users, and underweight/obesity, respectively. And there was no association between dietary fructose intake and the odds of having MetS after multivariate adjustment stratified by gender, smoking and alcohol use. CONCLUSIONS: Under the current dietary fructose intake status, there was no association between dietary fructose intake and the odds of having MetS among Chinese residents aged 45 and above. Physical activity and relatively low fructose intake may have a beneficial synergistic effect on MetS.


Assuntos
Síndrome Metabólica , China/epidemiologia , Estudos Transversais , Feminino , Frutose , Inquéritos Epidemiológicos , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Fatores de Risco
10.
Front Public Health ; 9: 619581, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34604147

RESUMO

Aim: We aimed to estimate the disease burden and risk factors attributable to ovarian cancer, and epidemiological trends at global, regional, and national levels. Methods: We described ovarian cancer data on incidence, mortality, and disability-adjusted life-years as well as age-standardized rates from 1990 to 2017 from the Global Health Data Exchange database. We also estimated the risk factors attributable to ovarian cancer deaths and disability-adjusted life-years. Measures were stratified by region, country, age, and socio-demographic index. The estimated annual percentage changes and age-standardized rates were calculated to evaluate temporal trends. Results: Globally, ovarian cancer incident, death cases, and disability-adjusted life-years increased by 88.01, 84.20, and 78.00%, respectively. However, all the corresponding age-standardized rates showed downward trends with an estimated annual percentage change of -0.10 (-0.03 to 0.16), -0.33 (-0.38 to -0.27), and -0.38 (-0.32 to 0.25), respectively. South and East Asia and Western Europe carried the heaviest disease burden. The highest incidence, deaths, and disability-adjusted life-years were mainly in people aged 50-69 years from 1990 to 2017. High fasting plasma glucose level was the greatest contributor in age-standardized disability-adjusted life-years rate globally as well as in all socio-demographic index quintiles and most Global Disease Burden regions. Other important factors were high body mass index and occupational exposure to asbestos. Conclusion: Our study provides valuable information on patterns and trends of disease burden and risk factors attributable to ovarian cancer across age, socio-demographic index, region, and country, which may help improve the rational allocation of health resources as well as inform health policies.


Assuntos
Carga Global da Doença , Neoplasias Ovarianas , Efeitos Psicossociais da Doença , Feminino , Humanos , Neoplasias Ovarianas/epidemiologia , Anos de Vida Ajustados por Qualidade de Vida , Fatores de Risco
11.
J Int Med Res ; 49(10): 3000605211028422, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605303

RESUMO

BACKGROUND: To identify the risk factors associated with rebleeding in obscure gastrointestinal bleeding (OGIB) patients from southern China. METHODS: This retrospective study involved 229 patients who underwent small bowel endoscopy in our hospital between 1 January 2018 and 1 December 2020. The clinical characteristics and risk factors related to rebleeding were retrospectively evaluated. RESULTS: Rebleeding patients were significantly older than non-rebleeding patients (53.0 ± 15.9 vs. 46.2 ± 17.8 years), had lower hemoglobin concentrations (89.2 ± 28.1 vs. 126.2 ± 25.1 g/L), and higher blood urea nitrogen concentrations (5.4 ± 2.6 vs. 4.5 ± 2.2 µmol/L), respectively. A higher percentage of rebleeding patients had diabetes mellitus (13.9% vs. 2.9%) and overt bleeding (70.4% vs. 38.6%), and required blood transfusions (43.1% vs. 8.0%), compared with non-rebleeding patients, respectively. Multivariate logistic analysis indicated that drinking alcohol (odds ratio (OR): 9.27; 95% confidence interval (CI) = 1.35-63.78), anemia (OR: 17.38; 95% CI = 5.48-55.10), and blood transfusion (OR: 3.76; 95% CI = 1.04-13.56) increased the risk of rebleeding in OGIB patients. CONCLUSION: Our data suggested that OGIB patients who drink alcohol, have anemia, and require blood transfusion have an increased risk of rebleeding.


Assuntos
Endoscopia por Cápsula , Hemorragia Gastrointestinal/etiologia , Humanos , Recidiva , Estudos Retrospectivos , Fatores de Risco
12.
Anticancer Res ; 41(10): 5065-5069, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34593456

RESUMO

BACKGROUND/AIM: Many patients with head-and-neck cancer are scheduled for irradiation. This study was performed to determine the frequency of and risk factors for pre-radiotherapy sleep disturbances in these patients. PATIENTS AND METHODS: A total of 103 patients with head-and-neck cancer scheduled for radiotherapy were included in this retrospective study. Eighteen characteristics were evaluated including timing of start of radiotherapy relative to COVID-19 pandemic; age; gender; Karnofsky performance score; Charlson comorbidity index; history of another malignancy; family history of malignancy; distress score; number of emotional, physical or practical problems; request for psychological support; tumor site and stage; upfront surgery; planned chemotherapy; and brachytherapy boost. RESULTS: The frequency of pre-radiotherapy sleep disturbances was 42.7%. This was significantly associated with age ≤63 years (p=0.049), Karnofsky performance score ≤80 (p=0.002), Charlson comorbidity index ≥3 (p=0.005), history of another malignancy (p=0.012), emotional (p=0.001) or physical (p<0.001) problems, and request for psychological support (p=0.002). CONCLUSION: Sleep disturbances were frequent in patients assigned to radiotherapy of head-and-neck cancer. Recognizing risk factors for sleep disturbance helps identify patients requiring psychological support.


Assuntos
Neoplasias de Cabeça e Pescoço/psicologia , Neoplasias de Cabeça e Pescoço/radioterapia , Transtornos do Sono-Vigília/psicologia , COVID-19/epidemiologia , Feminino , Neoplasias de Cabeça e Pescoço/epidemiologia , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Transtornos do Sono-Vigília/epidemiologia
13.
Anticancer Res ; 41(10): 5165-5169, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34593468

RESUMO

BACKGROUND/AIM: Many patients with prostate cancer receive definitive or adjuvant radiotherapy. This study aimed to identify the frequency of sleep disturbances and corresponding risk factors prior to radiation treatment. PATIENTS AND METHODS: Data of 48 patients assigned to local or loco-regional irradiation for prostate cancer were retrospectively analyzed for pre-radiotherapy sleep disturbances. Fifteen characteristics were analyzed including age, performance status, comorbidity, history of previous malignancy, distress score, (emotional, physical or practical) problems, prostate-specific antigen, primary tumor stage, Gleason-score, upfront androgen deprivation therapy (ADT), treatment volume, brachytherapy, and COVID-19 pandemic. RESULTS: Pre-radiotherapy sleep disturbances were reported by 20.8% of patients and significantly associated with distress scores ≥4 (p<0.0001) and ≥3 physical problems (p=0.0001). Trends were found for Karnofsky performance score ≤80 (p=0.095), Gleason score 7b-9 (p=0.079), and ADT (p=0.067). CONCLUSION: Pre-radiotherapy sleep disturbances were less common in prostate cancer patients than in other cancer patients. Risk factors were identified that can help identify patients requiring psychological support prior to radiotherapy.


Assuntos
Neoplasias da Próstata/psicologia , Neoplasias da Próstata/radioterapia , Transtornos do Sono-Vigília/psicologia , Idoso , COVID-19/epidemiologia , Humanos , Masculino , Prevalência , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/patologia , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Transtornos do Sono-Vigília/epidemiologia
14.
Khirurgiia (Mosk) ; (10): 45-51, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34608779

RESUMO

OBJECTIVE: To analyze endoscopic treatment of choledocholithiasis in patients over 80 years old. MATERIAL AND METHODS: A single-center retrospective study included 90 consecutive patients aged ≥80 years and 58 patients aged 60-79 years. Early outcomes including efficacy of calculus removal, incidence of complications and their risk factors were evaluated. RESULTS: In 75 patients aged ≥80 years (83.3%), endoscopic treatment was effective definitive single procedure. Between-group differences were insignificant (p=0.163). Patients aged ≥80 years were characterized by higher percentage of ASA classes 2-4 (p<0.001), age-adjusted mean Charlson comorbidity index (p=0.004), and ≥2 calculi (64.4% vs. 32.8%, p<0.001). Postoperative morbidity was similar (7.8% vs. 6.9%, p=0.842). Multivariate logistic regression analysis of potential risk factors did not reveal significant correlations: Chi-square test was 14.94 at 15 degrees of freedom (p=0.463). CONCLUSION: Similar postoperative morbidity determines safety of endoscopic lithoextraction in patients aged over 80 years. We should emphasize higher percentage of advanced age patients with «difficult¼ choledocholithiasis that requires appropriate training of specialists, adequate equipment of hospitals and routing of patients.


Assuntos
Coledocolitíase , Idoso de 80 Anos ou mais , Colangiopancreatografia Retrógrada Endoscópica , Coledocolitíase/diagnóstico , Coledocolitíase/cirurgia , Humanos , Estudos Retrospectivos , Fatores de Risco , Esfinterotomia Endoscópica , Resultado do Tratamento
16.
Acta Gastroenterol Belg ; 84(3): 401-405, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34599562

RESUMO

Patients and methods: A prospective registration of patients with colorectal cancer and a colonoscopy within the last 10 years. We tried to classify these post-colonoscopy colorectal cancers (PCCRCs) by most reasonable explanation and into subcategories suggested by the World Endoscopy Organization (WEO) and calculated the unadjusted PCCRC rate. Results: 47 PCCRCs were identified. The average age at diagnosis of PCCRC was 73 years. PCCRCs were more located in the right colon with a higher percentage of MSI-positive and B-RAF mutated tumours. The average period between index colonoscopy and diagnosis of PCCRC was 4.2 years. Sixty-eight % of all PCCRCs could be explained by procedural factors. The mean PCCRC-3y of our department was 2.46%. Conclusions: The data of our centre are in line with the data of the literature from which can be concluded that most postcolonoscopy colorectal cancers are preventable. The PCCRC-3y is an important quality measure for screening colonoscopy. Ideally all centres involved in the population screening should measure the PCCRC-3 y annually, with cooperation of the cancer registry and reimbursement data provided by the Intermutualistic Agency (IMA).


Assuntos
Neoplasias Colorretais , Colonoscopia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Humanos , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo
17.
J Nepal Health Res Counc ; 19(2): 221-229, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34601508

RESUMO

BACKGROUND: Pregnancy induced hypertension is a major cause of global maternal mortality and morbidity. This review was conducted to fulfill the objective of evaluating the status of pregnancy induced hypertension in Nepal. METHODS: The protocol for this review was registered in PROSPERO (CRD42020211210). Pubmed, Embase, Google Scholar, Scopus and Pubmed Central were searched using appropriate keywords for relevant studies. Data analysis was performed using Comprehensive Meta-Analysis Software version 3. Forest plot was used to visualize the prevalence and risk factors of Pregnancy induced hypertension. Random effect model was used and the level of heterogeneity was high. Joanna Briggins Institute bias assessment tool was used for the analysis of bias in the included studies. RESULTS: Twenty studies were included in the review. The pooled prevalence of pre-eclampsia and eclampsia were 2.6% (95% CI, 1.2%-5.3%) and 0.5% (95% CI, 0.2%-1.1%) respectively. The majority of cases were young women and had not complete or unbooked antenatal visits. Cesarean delivery was the most common mode of deliveries in 50% of deliveries (proportion, 0.50; 95% CI, 0.40-0.60) among patients with PIH followed by vaginal deliveries in 43.1% (proportion, 0.431; 95% CI, 0.336-0.532); and rest 6.9% were vacuum/forceps assisted deliveries (proportion, 0.069; 95% CI, 0.050-0.093). Common maternal complications were abruption in 6.56% of Pregnancy induced hypertension cases, rest were pulmonary embolism, renal injury. CONCLUSIONS: The prevalence of pre-eclampsia and eclampsia in Nepal were 2.6% and 0.5%. Younger woman and women with poor antenatal checkups had increased risk of Pregnancy induced hypertension. Cesarean delivery was the most common route of delivery and common maternal complications were abruption placenta, pulmonary embolism, renal injury etc. Keywords: Eclampsia; hypertension; maternal mortality; Nepal; pre-eclampsia; pregnancy-induced.


Assuntos
Hipertensão Induzida pela Gravidez , Estudos Transversais , Feminino , Humanos , Hipertensão Induzida pela Gravidez/epidemiologia , Nepal/epidemiologia , Gravidez , Prevalência , Fatores de Risco
18.
J Nepal Health Res Counc ; 19(2): 230-238, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34601509

RESUMO

BACKGROUND: Hypertension, diabetes, glomerulonephritis, obesity, and family history of kidney diseases are major risk factors for chronic kidney disease. Due to the paucity of data on a national level regarding the prevalence, risk factors, and complications of chronic kidney disease, we performed this meta-analysis. METHODS: We searched online databases from January 2000 till October 2020. Two reviewers screened articles using Covidence software. Comprehensive Meta-Analysis Software version 3 was used for data analysis. RESULTS: Among chronic kidney disease patients, 35.96% were found to have high LDL, 34.22% had hypercholesterolemia, 39.18% had hypertriglyceridemia, and 42.23% had low HDL. Pigmentary changes were reported in 37.71%, pruritus in 30.96%; and xerosis in 48.55%. Among the reported nail problems, the brown nail was reported in 7.19%, half and half nail in 6.07%, and white nail in 20.65%. CONCLUSIONS: The prevalence of chronic kidney disease among high-risk cohorts in Nepal was significant among risk group with hypertension and diabetes being the most common risk factors. The most common stage of chronic kidney disease was Stage V, and the common complications were skin problems and dyslipidemia.


Assuntos
Hipertensão , Insuficiência Renal Crônica , Humanos , Hipertensão/epidemiologia , Nepal/epidemiologia , Prevalência , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/etiologia , Fatores de Risco
19.
J Nepal Health Res Counc ; 19(2): 327-330, 2021 Sep 06.
Artigo em Inglês | MEDLINE | ID: mdl-34601525

RESUMO

BACKGROUND: An ectopic or extra uterine pregnancy is one in which the blastocyst implants anywhere other than the endometrial lining of the uterine cavity. The objective of the study was to find incidence, risk factors, clinical presentation and mode of management of ectopic pregnancy. METHODS: Observational study was conducted at Paropakar Maternity and Women's Hospital, Thapathali, Kathmandu. All the relevant data were recorded in performa. The collected data were entered in MS Excel and exported into SPSS 26 version for statistical analysis. RESULTS: About one third of the patients 10 (33.3%) was of 25-29 age group.The most common risk factor was pelvic infection in 23 (76.6%) cases, abortion in 11 (36.7%), and abdominal surgery in 8 (26.7%) of cases. The of classic triad of amenorrhea (100%), pain abdomen (99.7%) and per vaginal bleeding (66.7%). Ruptured ectopic seen in 26 (86.7%) cases, unruptured status in 1 (3.3%) case, tubal abortion in 1(3.3%) case and organized ectopic in 2(6.7%) cases. The most common site was found to be ampulla in 23 (76.7%) cases, fmbria 3(10%) cases, corneal in 3(10%) cases and ithmus in 1 (3.3%) case. All the cases managed surgically, of them unilateral salphingectomy, unilateral salphingo-opherectomy and wedge resection for corneal pregnancy were done in 25(83.3%), 2(6.7%) and 3(10%) cases respectively. CONCLUSIONS: Ectopic pregnancy mostly present as ruptured form in young females in our context. Pelvic infection is the commonest risk factor with ampulla being the commonest site. All cases required surgical intervention in form of unilateral salphingo-opherectomy and wedge resection.


Assuntos
Aborto Induzido , Gravidez Ectópica , Feminino , Humanos , Nepal/epidemiologia , Gravidez , Gravidez Ectópica/epidemiologia , Gravidez Ectópica/cirurgia , Fatores de Risco , Centros de Atenção Terciária
20.
J Coll Physicians Surg Pak ; 31(10): 1214-1218, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34601844

RESUMO

OBJECTIVE: To analyse clinicopathological variables to determine risk factors of postoperative pancreatic fistula in patients having distal pancreatectomy with stapler closure. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Adana City Training and Research Hospital, Adana, Turkey, from January 2015 to May 2020. METHODOLOGY: Medical files of 38 cases having distal pancreatectomy with stapler closure of the pancreatic remnant for conditions emerging from the pancreas or other organs were analysed. Data about demographics, perioperative and pathological findings, postoperative outcomes were gathered. Univariate analysis was utilised for comparisons of categorical data. The possible risk factors found to be significant in the univariate analysis were included into the logistic regression analysis. RESULTS: Based on the description reported by the International Study Group of Pancreatic Surgery, 23.7% and 31.6% of the patients had biochemical leakage and clinically relevant postoperative pancreatic fistula (POPF) respectively. Univariate and multivariate analyses made to determine risk factors of POPF showed a relation between stapler closure alone (p = 0.018) and soft parenchymal texture (p = 0.002) and clinically relevant POPF. Multivariate analyses revealed that parenchymal texture was the sole independent predictor of clinically relevant POPF (OR, 0.016, p = 0.039). CONCLUSION: Soft pancreatic texture is independently predictive of clinically relevant POPF following distal pancreatectomy with stapler closure. However, reinforcement of the stapler line with extra sutures decreases the risk of clinically relevant POPF. Key Words: Distal pancreatectomy, Pancreatic fistula, Stapler closure, Suture reinforcement.


Assuntos
Pancreatectomia , Fístula Pancreática , Humanos , Pâncreas , Pancreatectomia/efeitos adversos , Fístula Pancreática/epidemiologia , Fístula Pancreática/etiologia , Período Pós-Operatório , Fatores de Risco
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