RESUMO
OBJECTIVE: The objective was to develop a screening for heart disease detection in primary care, to identify pathological electrocardiographic changes and underlying heart disease in adolescents. DESIGN: The study was carried out for one year using multistage sampling. SITE: Primary care centers in a health area that had digital ECG equipment (12 centers) were selected. PARTICIPANTS: Initially, 718 (16.6%) 14-year-old adolescents were recruited and those with a previous diagnosis of heart disease were excluded. INTERVENTIONS: Screening consisted of including a health questionnaire in the mandatory 14-year-old check-up. MAIN MEASUREMENTS: Screening included a questionnaire, cardiac auscultation, ECG and echocardiography. Abnormality criteria were established to refer for a second evaluation by a cardiologist. RESULTS: Finally, the sample was made up of 698 adolescents, with a mean age of 13.7±0.5 years, and 354 (50.7%) were boys. A total of 149 (21.3%) were selected for a second review by cardiology: 88 (12.6%) due to a positive questionnaire, 11 (2.2%) due to abnormal cardiac auscultation, and 66 (9.5%) due to ECG findings. Adolescents with evidence of heart disease were 24 (3.4%). Of these, 14 (2.0%) had suggestive alterations and follow-up was recommended, 6 (0.9%) had a definitive diagnosis of heart disease, and 4 (0.6%) had other pathological findings related to the cardiovascular system. CONCLUSIONS: The screening allowed us to identify 1% of adolescents with heart disease and another 2% will remain in follow-up. The ECG detected more pathological cases than the questionnaire.
Assuntos
Morte Súbita Cardíaca , Cardiopatias , Masculino , Humanos , Adolescente , Feminino , Morte Súbita Cardíaca/prevenção & controle , Eletrocardiografia , Cardiopatias/diagnóstico , Ecocardiografia , Programas de RastreamentoRESUMO
INTRODUCTION: Extended reality (XR) is the ensemble of interactive experiences based on a computer-simulated environment that encompasses virtual reality and augmented reality and has been proven to be potentially innovative in the field of health education with adolescents. The objective of this study is to present a systematic review and meta-analysis protocol that seeks to evaluate the main effects of interventions that use XR on health parameters (food intake, sound quality and physical activity) of adolescent students. METHODS AND ANALYSIS: The literature search will be performed in the following databases: MEDLINE, Embase, Scopus, ERIC, ScienceDirect, Web of Science, Cochrane, LILACS, APA and ADOLEC. Intervention studies (clinical trials-randomised or non-randomised) and quasi-experimental studies will be included. The risk of bias will be assessed using the Risk of Bias in Non-randomized Studies of Interventions tool for randomised controlled trials (RCTs), non-RCTs and quasi-experimental trials. Two independent researchers will conduct all the assessments, and any disagreements will be consulted with a third reviewer. Data analysis and synthesis will be performed using RevMan V.5.4.1 software. The study will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guideline. ETHICS AND DISSEMINATION: Ethical approval and human consent were not required, as this is a protocol for a systematic review and only secondary data will be used. The findings will be published in a journal and presented at conferences. In case of any changes to this protocol, it will be updated in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses website, and the modifications will be explained in the final report of this review. PROSPERO REGISTRATION NUMBER: CRD42022373876.
Assuntos
Exercício Físico , Educação em Saúde , Humanos , Adolescente , Revisões Sistemáticas como Assunto , Metanálise como Assunto , Instituições Acadêmicas , Projetos de Pesquisa , Literatura de Revisão como AssuntoRESUMO
OBJECTIVES: . The main purpose of this simulation of a multiple-casualty event was to compare the performance of 2 triage methods: the Simple Triage and Rapid Treatment (START) system and the Prehospital Advanced Triage Model (META in its Spanish acronym). The secondary objectives were to analyze times, order of evacuations, and appropriateness of treatments. MATERIAL AND METHODS: Cluster randomized trial that included 16 groups assigned to use either the START system or the META for managing casualties in a simulated event (an airline crash). Each group had 4 members. We recorded times, order of evacuation, and appropriateness of treatment. RESULTS: The mean (SD) evacuation time was 48 minutes and 39 seconds (15 minutes, 52 seconds) in the START arm and 48 minutes and 4 seconds (17 minutes, 21 seconds) in the META arm (P=.829). The patients with greatest need of immediate care were evacuated more quickly in the META arm (31 minutes and 36 seconds [8 minutes, 27 seconds]) than in the START arm (41 minutes and 6 seconds [10 minutes, 39 seconds]) (P=.024). Evacuation of the subgroup of patients requiring emergency surgery was also faster in the META arm (24 minutes and 12 seconds [4 minutes] than in the START arm (44 minutes and 49 seconds [8 minutes, 36 seconds]) (P=.001). Analysis of the order of evacuation under the 2 triage systems revealed that 14 of the first 19 patients evacuated required immediate medical care and 5 of the first 14 evacuated required priority surgical treatment in the START arm. In the META arm, all of the first 14 patients evacuated required immediate medical care and 5 of the first 7 patients evacuated required priority surgical treatment. The rate of appropriate treatment was 92% in the META arm and 63% in the START arm (P=.023). CONCLUSION: Use of the META system might improve prehospital times and the order of evacuation of patients, particularly patients who need immediate medical care or urgent surgery. The META might also increase the likelihood of appropriate treatment in multiple-casualty events.
OBJETIVO: El objetivo principal fue comparar dos sistemas de triaje (Simple Triage and Rapid Treatmet, START vs. Modelo Extrahospitalario de Triaje Avanzado, META) en un mismo incidente simulado de múltiples víctimas (IMV). Los objetivos secundarios fueron analizar los tiempos y el orden de evacuación, y la adecuación del tratamiento. METODO: Ensayo aleatorizado por conglomerados que incluyó 16 grupos de 4 miembros asignados al sistema de triaje START o META en un ejercicio simulado de gestión a las víctimas de un accidente aéreo. Se recogieron los tiempos y el orden de evacuación, y la adecuación del tratamiento. RESULTADOS: El tiempo de evacuación total fue de 48 min 39 s (DE 15 min 52 s) en el grupo START y de 48 min 4 s (DE 17 min 21 s) en el grupo META (p = 0,829). Los pacientes con necesidad de atención inmediata se evacuaron más rápidamente en el grupo META que en el START, tanto en el grupo completo (31 min 36 s [DE 8 min 27 s] vs 41 min 6 s [DE 10 min 39s ]; p = 0,024) como en los que además precisaban tratamiento quirúrgico urgente (24 min 12 s [DE 4 min] vs 44 min 49 s [DE 8 min 36 s]; p = 0,001). El orden de evacuación de pacientes fue: los de necesidad de atención inmediata en las 19 primeras posiciones (14 de 19) y de atención inmediata con prioridad quirúrgica en las 14 primeras posiciones (5 de 14) en el grupo START; y los de necesidad de atención inmediata en las 14 primeras posiciones (14 de 14) y de atención inmediata y con prioridad quirúrgica en las 7 primeras posiciones (5 de 7) en el grupo META. La frecuencia de tratamiento adecuado fue de un 92% en el caso del META y de un 63% en el caso del START (p = 0,023). CONCLUSIONES: El triaje META, en comparación con el START, podría mejorar los tiempos extrahospitalarios y el orden de evacuación de los pacientes, especialmente en el caso de aquellos con necesidad de atención inmediata y de atención inmediata con prioridad quirúrgica, así como la adecuación del tratamiento, en los IMV.