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Arch. argent. pediatr ; 120(5): 346-353, oct. 2022. tab, ilus
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1391193


Los trastornos funcionales gastrointestinales (TFGI) se caracterizan por síntomas atribuibles al tracto gastrointestinal que no pueden ser explicados por anormalidades estructurales ni bioquímicas. Durante el primer año de vida, pueden generar mucho malestar en el lactante y preocupación en sus padres. Su diagnóstico se basa en criterios clínicos que expertos han determinado y en una historia clínica y un examen físico completo que descartan causas orgánicas. El objetivo de esta actualización es presentar estrategias para el manejo de los TFGI más frecuentes durante el primer año de vida: cólicos, regurgitaciones, disquecia y estreñimiento, bajo la visión de los nuevos conocimientos fisiopatológicos, que eviten los estudios y medicaciones innecesarias.

Functional gastrointestinal disorders (FGIDs) are characterized by symptoms attributable to the gastrointestinal tract that cannot be explained by the presence of structural or biochemical abnormalities. During the first year of life, FGIDs can cause great discomfort in infants and concern in their parents. The diagnosis of FGIDs is based on clinical criteria determined by experts and on a comprehensive case-taking process and physical exam to rule out organic causes. The objective of this update is to describe strategies for the management of the most frequent FGIDs during the first year of life: colics, regurgitations, dyschezia, and constipation, in light of new pathophysiological insights, to avoid unnecessary tests and medications.

Humans , Infant, Newborn , Infant , Colic , Gastrointestinal Diseases/diagnosis , Gastrointestinal Diseases/etiology , Gastrointestinal Diseases/therapy , Vomiting , Prevalence , Constipation/diagnosis , Constipation/drug therapy
Medicina UPB ; 41(1): 85-90, mar. 2022. Ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1362717


Se presenta el caso de una mujer en la quinta década de la vida que ingresa al servicio de urgencias con manifestaciones gastrointestinales consistentes en vómito e hipo. Después de múltiples estudios e intervenciones por especialistas, se piensa en el origen central de los síntomas. Se realiza una resonancia magnética nuclear (RMN) cerebral que permite el enfoque del caso y posterior confirmación del diagnóstico de una enfermedad dentro del espectro de la neuromielitis óptica, positiva para anticuerpos anti-acuaporinas-4. El tratamiento con esteroide y anticuerpo monoclonal (Rituximab) llevan a un control adecuado de la enfermedad.

We present a case report of a woman in her 50s admitted to the emergency room with gastrointestinal manifestations consisting of vomiting and hiccups. After a series of studies and interventions by specialists, a brain magnetic resonance imaging (MRI) is performed in order to find the central origin of the symptoms. This allows the approach of the case and subsequent confirmation of the diagnosis of Neuromyelitis optica, positive for anti-acuaporin-4 antibodies. Finally, it seems that treatment with steroids and monoclonal antibodies leads to proper control of the disease.

Se apresenta o caso de uma mulher na quinta década de vida que ingressa ao serviço de urgências com manifestações gastrointestinais consistentes em vômito e soluço. Depois de múltiplos estudos e intervenções por especialistas, se pensa na origemcentral dos sintomas. Se realiza uma ressonância magnética nuclear (RMN) cerebral que permite o enfoque do caso e posterior confirmação do diagnóstico de uma doença dentro do espectro da neuromielite óptica, positiva para anticorpos anti-acuaporinas-4. O tratamento com esteroide e anticorpo monoclonal (Rituximab) levam a um controle adequado da doença.

Humans , Neuromyelitis Optica , Vomiting , Brain , Magnetic Resonance Imaging , Aquaporins , Hiccup , Antibodies
Chinese Journal of Burns ; (6): 683-690, 2022.
Article in Chinese | WPRIM | ID: wpr-940975


Objective: To investigate the effects of compound analgesia on ultra-pulsed fractional carbon dioxide laser (UFCL) treatment of post-burn hypertrophic s in children. Methods: A prospective randomized controlled study was conducted. From April 2018 to March 2020, 169 pediatric patients with post-burn hypertrophic s admitted to the First Affiliated Hospital of Air Force Medical University were randomly divided into general anesthesia alone group (39 cases, 19 males and 20 females, aged 35 (21, 48) months), general anesthesia+lidocaine group (41 cases, 23 males and 18 females, aged 42 (22, 68) months), general anesthesia+ibuprofen suppository group (41 cases, 25 males and 16 females, aged 38 (26, 52) months), and three-drug combination group with general anesthesia + lidocaine+ibuprofen suppository (48 cases, 25 males and 23 females, aged 42 (25, 60) months), and the pediatric patients in each group were treated with corresponding analgesic regimens when UFCL was used to treat s, and the pediatric patients were given comprehensive care throughout the treatment process. The pain degree of pediatric patients scar was evaluated by facial expression,legs,activity,cry,and consolability (FLACC) of children's pain behavior scale at 0 (immediately), 1, 2, and 4 h after awakening from the first anesthesia, respectively. At 4 h after awakening from the first anesthesia of postoperative pain assessment, the self-made analgesia satisfaction questionnaire was used to evaluate the satisfaction for the analgesic effect of the pediatric patients or their families, and the satisfaction rate was calculated. Within 2 h after the first operation, the occurrences of adverse reactions of the pediatric patients, such as nausea and vomiting, headache, dizziness, drowsiness, etc, were observed and recorded. Before the first treatment and 1 month after the last treatment, the Vancouver scar scale (VSS) was used to evaluate the pediatric patients scar, and the difference value between the two was calculated. Data were statistically analyzed with least significant difference test, Kruskal-Wallis H test, chi-square test and Fisher's exact probability test. Results: At 0 h after awakening from the first anesthesia, the FLACC scores of pediatric patients in general anesthesia+lidocaine group, general anesthesia+ibuprofen suppository group and three-drug combination group were significantly lower than those in general anesthesia alone group (P<0.01). The FLACC scores of the pediatric patients in anesthesia+ibuprofen suppository group and three-drug combination group were significantly lower than that in general anesthesia+lidocaine group (P<0.01), and the FLACC score of the pediatric patients in three-drug combination group was significantly lower than that in general anesthesia+ibuprofen suppository group (P<0.01). At 1 and 2 h after awakening from the first anesthesia, the FLACC scores of pediatric patients in general anesthesia+ibuprofen suppository group and three-drug combination group were both significantly lower than those in general anesthesia alone group and general anesthesia+lidocaine group (P<0.01), and the FLACC score of the pediatric patients in three-drug combination group was significantly lower than that in general anesthesia+ibuprofen suppository group (P<0.01). At 4 h after awakening from the first anesthesia, the FLACC scores of the pediatric patients in general anesthesia+ibuprofen suppository group and three-drug combination group were significantly lower than those in general anesthesia alone group and general anesthesia+lidocaine group (P<0.01). At 4 h after awakening from the first anesthesia, the satisfactions rate with the analgesic effect in the four groups of pediatric patients or their families were 79.49% (31/39), 85.37% (35/41), 87.80% (36/41), and 97.92% (47/48), respectively. The satisfaction rate of the pediatric patients in three-drug combination group was significantly higher than those in general anesthesia alone group, general anesthesia+lidocaine group, general anesthesia+ibuprofen suppository group. Within 2 h after the first operation, there was no significant difference in the overall comparison of adverse reactions such as nausea and vomiting, headache, dizziness, and drowsiness of pediatric patients among the 4 groups (P>0.05). The VSS scores of pediatric patients before the first treatment, 1 month after the last treatment, and and the difference value between the two in the 4 groups were not significantly different (P>0.05). Conclusions: Three-drug combination for analgesia has a good effect in the treatment of hypertrophic scars after burn in pediatric patients with UFCL. Pediatric patients or their families are highly satisfied with the effect, and the treatment effect and incidence of adverse reactions are similar to other analgesic regimens, so it is recommended to be promoted in clinical practice.

Analgesia , Analgesics , Child , Cicatrix, Hypertrophic/pathology , Dizziness/drug therapy , Female , Headache/drug therapy , Humans , Ibuprofen/therapeutic use , Lasers, Gas/therapeutic use , Lidocaine , Male , Nausea/drug therapy , Pain/drug therapy , Prospective Studies , Treatment Outcome , Vomiting/drug therapy
Article in Chinese | WPRIM | ID: wpr-928613


OBJECTIVES@#To study the clinical features of children with colorectal polyps and the efficacy of endoscopic treatment.@*METHODS@#A retrospective analysis was performed on the medical data of 1 351 children with colorectal polyps who were admitted and received colonoscopy and treatment in the past 8 years, including clinical features and the pattern and outcomes of endoscopic treatment.@*RESULTS@#Among the 1 351 children, 893 (66.10%) were boys and 981 (72.61%) had an age of 2-<7 years, and hematochezia (1 307, 96.74%) was the most common clinical manifestation. Of all the children, 89.27% (1 206/1 351) had solitary polyps, and 95.77% (1 290/1 347) had juvenile polyps. The polyps were removed by electric cauterization with hot biopsy forceps (6 cases) or high-frequency electrotomy and electrocoagulation after snare ligation (1 345 cases). A total of 1 758 polyps were resected, among which 1 593 (90.61%) were pedunculated and 1 349 (76.73%) had a diameter of <2 cm. Postoperative complications included bleeding in 51 children (3.77%), vomiting in 87 children (6.44%), abdominal pain in 14 children (1.04%), and fever in 39 children (2.89%), while no perforation was observed. The children aged <3 years had the highest incidence rates of postoperative bleeding and fever (P<0.0125), and the children with a polyp diameter of ≥2 cm had significantly higher incidence rates of postoperative bleeding, vomiting, and fever (P<0.05).@*CONCLUSIONS@#Solitary polyps, pedunculated polyps, and juvenile polyps are common types of pediatric colorectal polyps. Electric cauterization with hot biopsy forceps or high-frequency electrotomy and electrocoagulation after snare ligation can effectively remove colorectal polyps in children, with good efficacy and few complications. Younger age and larger polyp diameter are associated with a higher risk of postoperative bleeding.

Child , Colonic Polyps/surgery , Colonoscopy , Female , Humans , Intestinal Polyps/surgery , Male , Retrospective Studies , Vomiting
Article in Chinese | WPRIM | ID: wpr-927431


OBJECTIVE@#To systematically review the therapeutic effect of acupuncture and moxibustion on postoperative gastrointestinal dysfunction (GID) of gastric cancer with meta-analysis.@*METHODS@#The articles of randomized controlled trials (RCTs) of acupuncture and moxibustion treatment for postoperative GID of gastric cancer were retrieved from the following databases from the time of database establishment to December 31, 2020, including PubMed, EMbase, Cochrane Central Register of Controlled Trials (CENTRAL), China National Knowledge Infrastructure (CNKI), Wanfang database, VIP database and China Biomedical Literature Database (SinoMed). RevMan5.3 software was used for meta-analysis. Using Stata16.0 software, sensitivity analysis and publication bias test were performed.@*RESULTS@#A total of 16 RCTs were included finally, including 1 360 patients, of which, there were 681 cases in the intervention group and 679 cases in the control group. Meta-analysis results showed that acupuncture and moxibustion shortened the time of first flatus (P<0.000 01, MD =-14.52, 95%CI = [-17.31, -11.74]), the time of first bowel sound (P<0.000 01, MD =-10.50, 95%CI =[-13.99, -7.01]) and the time of first defecation (P<0.000 1, MD =-13.79, 95%CI =[-20.09, -7.50]). Meanwhile, acupuncture and moxibustion shortened the time of the first food intake (P<0.000 1, MD =-3.23, 95%CI = [-3.45, -3.00]) and the hospital stay (P<0.000 01, MD =-1.94, 95%CI =[-2.20, -1.69]) after gastric cancer operation, and reduced the incidences of postoperative adverse reactions, i.e. nausea and vomiting (P =0.000 3, RR =0.43, 95%CI =[0.28, 0.68]) and abdominal distention (P =0.000 5, RR =0.41, 95%CI =[0.25, 0.68]).@*CONCLUSION@#Acupuncture and moxibustion can promote the recovery of postoperative gastrointestinal function in the patients with gastric cancer. But, for the comparison among different measures of acupuncture and moxibustion intervention, it needs more high-quality trials for a further verification.

Acupuncture Therapy/methods , Humans , Moxibustion/methods , Nausea , Stomach Neoplasms/surgery , Vomiting
Ethiop. j. health dev. (Online) ; 36(2): 1-7, 2022-06-07. Tables
Article in English | AIM | ID: biblio-1379849


Background:An abnormality that causes reflux is termed as Gastroesophageal reflux disease (GERD), which is symptomatic by nature and adds to the long-term effects.Objective:The aim of this study is to observe and monitor the effects of a herbal ttratment of GERD with SiniZuojin Decoction (SNZID)and to assess its mediation impacts regarding the use of the medication in patients with Gastrointestinal EBB ailment.Materials and Methods:The cohort research methodology was used inthe study.The research included 2581 individual patients who were older than 18 years of age and were suffering from Gastrointestinal ebbailment. The patients were selected from various government herbal clinics in eastern China, including the states of Anhui, Fujian, Jiangsu, Jiangxi, Shandong, and Zhejiangover, from 2008 to 2018. Results:The study was conducted with a total of 2581 patients. The thorough assessment indicated that Sini Zuojin Decoction (SZD)notwithstanding standard stomach remedies pack was more effective than the traditionalist stomach suppositories bundle (RR=1.34, with CI=95% [1.47, 1.38], and P-value = 0.008); Test packs including SZD was essentially better contrasted with traditional stomach medicines(TSM)gearshifts in developing dyspepsia, substernal chest plague, decreasing regurgitation, and vomiting (P < 0.0002); SNZJD plus traditional stomach medicines(SPTSM)could by and large lessen full-scale sign scores with liberal ampleness (P < 0.00002). The replication degree and antagonistic effects regarding Sacroiliac Joint Dysfunction(SJD)treatment were basic. As confirmed through the TSA regarding thorough assessment, the results were significant, yet repeat security consequences were uncertain. As shown by the computation of the Grading of Recommendations Assessment, Development and Evaluation(GRADE)strategy, the idea regarding verification was minimal. Moreover, Schizoaffective disorder(SZD)may treat Gastrointestinal ebb ailment by presenting the onsetof the infection and controlling factors that may contribute to Gastrointestinal ebb ailments.Conclusion:The research evaluated the efficiency of Sini Zuojin Decoction in treating patients suffering from Gastrointestinal Ebb Ailments. [Ethiop. J. Health Dev.2022: 36(2) (00-00)]Keywords:GERD, Esophagitis, Sini Zuojin Decoction(SZD), Gastrointestinal ebb ailment;

Patients , Stomach Diseases , Gastroesophageal Reflux , Gastrointestinal Diseases , Vomiting , Esophagitis, Peptic
Rev. Bras. Cancerol. (Online) ; 68(1)jan./fev./mar. 2022.
Article in Portuguese | LILACS | ID: biblio-1370558


Introdução: Náuseas e vômitos induzidos por quimioterapia acometem cerca de 70-80% dos pacientes com câncer. Assim, é importante a utilização de um instrumento para avaliar melhor esses sintomas, visando a um tratamento mais adequado. Objetivo: Traduzir e adaptar culturalmente a escala Morrow Assessment of Nausea and Emesis para o contexto brasileiro. Método: Estudo correlacional do tipo survey, com tradução e adaptação cultural da escala segundo o protocolo da European Organization for Research and Treatment of Cancer ­ Quality of Life Group (EORTC-QLG). A amostra foi constituída por 160 pacientes em tratamento quimioterápico em uma clínica de oncologia. No processo de validação, realizaram-se análises de correlação multimétodos entre os itens da escala Morrow Assessment of Nausea and Emesis e os escores das escalas visuais numéricas de náusea e vômito com nível de p<0,05. Resultados: O autor da escala autorizou a tradução. A escala Morrow Assessment of Nausea and Emesis e as escalas numéricas apresentaram correlações significativas (p<0,01; p<0,05), sendo que os itens que apresentaram correlação mais forte das escalas numéricas foram os que se referiram à avaliação de náusea e vômito pós-quimioterapia. Já os itens destinados à avaliação desses sintomas no momento pré-quimioterapia e ao uso da medicação antiemética e sua eficácia apresentaram associações fracas com as escalas numéricas. Conclusão: A escala Morrow Assessment of Nausea and Emesisapresentou-se adequada para a avaliação de náuseas e vômitos induzidos por quimioterapia no contexto brasileiro

Introduction: Chemotherapy-induced nausea and vomiting affects nearly 70-80% of patients with cancer. To achieve a better treatment it is important to utilize an adequate instrument to assess these symptoms. Objective:To translate and culturally adapt the Morrow Assessment of Nausea and Emesis Scale to the Brazilian context. Method: Survey and correlational study, with the translation and cultural adaptation of the scale according to the protocol of the European Organization for Research and Treatment of Cancer ­ Quality of Life Group (EORTC-QLG). The sample consisted of 160 patients undergoing chemotherapy treatment in an oncology clinic. In the validation process, multimethod correlation analyses were carried out among the items of the Morrow Assessment of Nausea and Emesis Scale items and the scores of the numerical visual scales of nausea and vomits at the level of p<0.05. Results: The author of the scale approved the translation process. The Morrow Assessment of Nausea and Emesis scale and the numerical scales presented significant correlations (p<0.01; p<0.05), considering that the items presenting stronger correlation with the numerical scales were those addressing post-chemotherapy assessment of nausea and vomit. On the other hand, the items for pre-chemotherapy assessment of these symptoms and use of the antiemetic drugs and their efficacy presented weak associations with the numerical scales. Conclusion: The Morrow Assessment of Nausea and Emesis scale was adequate for the assessment of chemotherapy-induced nausea and vomiting in the Brazilian context

Introducción: Las náuseas y vómitos inducidos por la quimioterapia afectan aproximadamente al 70-80% de los pacientes con cáncer. Por lo tanto, es importante utilizar un instrumento para evaluar mejor estos síntomas, con el objetivo de un tratamiento más adecuado. Objetivo: Traducir y adaptar culturalmente la escala de Morrow Assessment of Nausea and Emesisal contexto brasileño. Método: Estudio correlativo del tipo de encuesta, con la traducción y adaptación cultural de la escala según el protocolo de la European Organization for Research and Treatment of Cancer ­ Quality of Life Group (EORTC-QLG). La muestra consistió en 160 pacientes sometidos a quimioterapia en una clínica oncológica. En el proceso de validación, se realizaron análisis de correlación multimétodos entre los elementos de la escala de Morrow Assessment of Nausea and Emesis y las puntuaciones de las escalas visuales numéricas de náuseas y vómitos con nivel de p<0,05. Resultados: El autor de la escala autorizó la traducción. La Morrow Assessment of Nausea and Emesis y las escalas numéricas mostraron correlaciones significativas (p<0,01; p<0,05), y los elementos que presentaron una correlación más fuerte de las escalas numéricas fueron los que se refirieron a la evaluación de las náuseas y los vómitos después de la quimioterapia. Por otro lado, los elementos destinados a la evaluación de estos síntomas en el momento anterior a la quimioterapia y el uso de medicamentos antieméticos y su eficacia presentaron asociaciones débiles con escalas numéricas. Conclusión: La Morrow Assessment of Nausea and Emesis fue adecuada para la evaluación de náuseas y vómitos inducidos por quimioterapia en el contexto brasileño

Humans , Male , Female , Vomiting , Validation Study , Drug Therapy , Medical Oncology , Nausea
Braz. J. Pharm. Sci. (Online) ; 58: e191123, 2022. tab, graf
Article in English | LILACS | ID: biblio-1394050


Chemotherapy induced nausea and vomiting (CINV) and post-operative nausea and vomiting (PONV) is a problem, often occurs in patient. Inspite of high bioavailability, the demerits such as: hepatic first pass metabolism and invasive nature of oral and parenteral dosage forms can be avoided with anti-emetic therapy of transdermal device. The major objective of the present study is to modify the hydrochloride (HCl) form of Ondansetron (OND) to the base form followed by improvement of solubility and permeability of OND by employing solid dispersion (SD) loaded patches. Preformulation study, as observed, begins with an approach to enthuse solubility of OND by SD technique choosing different carriers. The choice of carriers was rationalized by phase solubility study. Several combinations of transdermal films were prepared with pure drug, carriers and SDs with plasticizer Ka values of OND-HPßCD binary system were found lower (54.43 to 187.57 M-1) than that of OND-PVP K-30 binary system (1156.77 to 12203.6 M-1). The drug content of SDs and patches were found satisfactory. Better permeation rate (236.48±3.66 µg/3.935 cm2) with promising flux enhancement (8.30 fold) was found with DBP loaded SD patch (P6*). Hence, enhancement of solubility and permeability of P6* ensures that it can successfully enhance the bioavailability

Plasticizers/adverse effects , Solubility , Ondansetron/antagonists & inhibitors , Patients/classification , Vomiting , Pharmaceutical Preparations/analysis , Postoperative Nausea and Vomiting , Dosage Forms , Drug Therapy/instrumentation , Methods , Motion Pictures/classification
Rev. colomb. gastroenterol ; 36(3): 377-383, jul.-set. 2021. graf
Article in English, Spanish | LILACS | ID: biblio-1347354


Resumen El adenocarcinoma de yeyuno es el tumor primario del intestino delgado más infrecuente y raro, y representa el 3 % de todos los cánceres gastrointestinales, con una incidencia anual estimada de 0,3 a 2 casos por cada 100 000 personas. En Estados Unidos y España representa el 0,4 % de los cánceres gastrointestinales y el 0,2 % de las muertes asociadas a malignidad, con síntomas inespecíficos como anemia de etiología inexplicable, dolor abdominal y pérdida de peso; la mayoría de ellos son diagnosticados en etapas avanzadas de la enfermedad. A continuación, se presenta el caso de una paciente femenina de 46 años con síntomas inespecíficos, pérdida de peso, dolor abdominal y vómito, cuya tomografía abdominal computarizada evidenció el sitio y extensión de la lesión neoplásica, mientras que la cápsula endoscopia y enteroscopia mostró una lesión neoplásica en el yeyuno proximal. La histopatología reportó un adenocarcinoma de yeyuno moderadamente diferenciado que presentó resultados favorables gracias a la resección quirúrgica curativa, lo cual mejoró el pronóstico de vida a 5 años y tuvo un seguimiento favorable hasta la actualidad.

Abstract Jejunal adenocarcinoma is the rarest primary small bowel tumor and represents 3% of all gastrointestinal cancers, with an estimated annual incidence of 0.3 to 2 cases per 100 000 people. This disease accounts for 0.4% of gastrointestinal cancers and 0.2% of deaths associated with malignancy in the United States and Spain, with nonspecific symptoms, such as anemia of unexplained etiology, abdominal pain, and weight loss; most cases are diagnosed in advanced stages of the disease. The following is the case of a 46-year-old female with non-specific symptoms, weight loss, abdominal pain and vomiting. A computerized tomography scan of the abdomen allowed determining the site and extension of the tumor, while a capsule endoscopy and an enteroscopy showed a neoplastic lesion in the proximal jejunum. A histopathology analysis reported moderately differentiated adenocarcinoma of jejunum with favorable results after a curative surgical resection that improved the prognosis of life at 5 years and with favorable follow-up until to date.

Humans , Female , Middle Aged , Adenocarcinoma , Intestine, Small , Jejunum , Neoplasms , Vomiting , Tomography , Weight Loss , Abdominal Pain
Rev. cuba. med. trop ; 73(2): e609, 2021. graf
Article in English | LILACS, CUMED | ID: biblio-1347498


Coleopteran insects can produce toxic substances containing multiple components which have so far not been properly described. To report an unusual case of intoxication by excretion from Calosoma alternans Fabricius 1792 (Coleoptera: Carabidae) in a Venezuelan patient from a periurban neighborhood near the mesothermal raining forest. The toxic activity caused a clinical status characterized by digestive symptoms such as nausea, vomiting, epigastralgia, an increase in bowel movements and probable kidney inflammation with intense pain in both lumbar regions, which did not correspond to the classic dermal damage. In conclusion, a unique case is presented of intoxication by a coleopteran species, with a clinical description not previously reported(AU)

Los insectos coleópteros pueden producir sustancias tóxicas que contienen numerosos componentes que aún no han sido descritos adecuadamente. Presentar un caso inusual de intoxicación por excreciones de Calosoma alternans Fabricius 1792 (Coleoptera: Carabidae) en un paciente venezolano residente en un barrio periurbano cercano a la selva tropical mesotérmica. La actividad tóxica provocó un cuadro clínico caracterizado por síntomas digestivos como náuseas, vómitos, epigastralgia, aumento del número de deposiciones y probablemente inflamación renal, con dolor intenso en ambas regiones lumbares, lo que no se corresponde con el daño dérmico clásico. En resumen, se presenta un caso singular de intoxicación provocada por una especie de coleóptero, con una descripción clínica no reportada anteriormente(AU)

Humans , Male , Signs and Symptoms , Coleoptera , Insecta , Poisoning , Venezuela , Vomiting , Toxic Substances
Arq. Asma, Alerg. Imunol ; 5(2): 189-194, abr.jun.2021. ilus
Article in Portuguese | LILACS | ID: biblio-1398928


A síndrome da enteropatia induzida por proteína alimentar, aguda ou crônica, é um tipo de alergia alimentar não mediada por IgE, que surge entre os 5 e 9 meses de idade, e é caracterizada por episódios de vômitos que começam aproximadamente 1 a 4 horas após a ingestão do alérgeno, algumas vezes acompanhados de letargia, palidez cutânea e diarreia com sangue, resultando em instabilidade hemodinâmica e choque em 15% dos casos. Sua epidemiologia em larga escala é desconhecida, assim como o mecanismo imunopatológico, no entanto, sugere-se um papel importante das células T no processo inflamatório. As manifestações e a gravidade dependem da frequência e da dose do alimento desencadeante, bem como do fenótipo e da idade de cada paciente. A suspeita se dá com base principalmente na história clínica e nos sintomas característicos da doença, que tendem a melhorar após a retirada do alimento suspeito. O teste de provocação oral é o padrão ouro para o diagnóstico, mas deve ser reservado para os casos em que a história é confusa e a hipótese incerta. A abordagem de primeira linha no tratamento visa corrigir a desidratação ou estabilizar o choque quando presente, e interromper imediatamente a oferta de alimentos com potencial indutor de reação alérgica. Relatamos o caso de uma lactente de 2 meses de idade com diagnóstico da síndrome, cujo objetivo é atentar o leitor quanto as suas particularidades, auxiliando-o no diagnóstico precoce e adequado a fim de evitar a depleção progressiva e a evolução para sua forma potencialmente grave.

Acute or chronic food protein-induced enteropathy syndrome is a type of non-IgE-mediated food allergy occurring between 5 and 9 months of age. It is characterized by episodes of vomiting that begin approximately 1 to 4 hours after allergen intake, sometimes accompanied by lethargy, skin pallor, and bloody diarrhea, leading to hemodynamic instability and shock in 15% of cases. Its epidemiology is largely unknown, as well as its immunopathological mechanism; however, an important role of T cells in the inflammatory process is observed. Manifestations and severity depend on the frequency and dose of the triggering food, as well as the phenotype and age of each patient. Suspicion is based mainly on clinical history and characteristic symptoms of the disease, which tend to improve after the removal of the suspect food. Oral provocation testing is the gold standard for diagnosis, but it should be reserved for cases whose history is confusing and hypothesis is uncertain. The first-line treatment approach seeks to correct dehydration or to stabilize shock, if present, and to immediately stop the supply of food that potentially induce an allergic reaction. We report the case of a 2-month-old infant diagnosed with the syndrome, with the aim of drawing the readers' attention to its particularities, thus assisting in early and adequate diagnosis in order to avoid progressive depletion and deterioration to its potentially severe form.

Humans , Female , Infant , Vomiting , Proteins , Diarrhea , Enterocolitis , Food Hypersensitivity , Signs and Symptoms , Therapeutics , Immunoglobulin E , T-Lymphocytes , Diagnosis, Differential , Eating , Lethargy
Arq. Asma, Alerg. Imunol ; 5(2): 203-207, abr.jun.2021. ilus
Article in English | LILACS | ID: biblio-1398933


Allergy to persimmon (Diospyros kaki ) has been only rarely reported. The antigenic composition of the fruit is not entirely known. Thaumatin-like proteins (TLPs) have been described as allergens in pollens and various fruits, such as kiwi and banana, but not in persimmon. We report the case of a 22-year-old man, with persistent moderate-to-severe allergic rhinitis, sensitized to house dust mites. The patient describes an episode of oral mucosa and ear canal pruritus, followed by diffuse urticaria, which rapidly evolved to dysphonia, dyspnea, and dizziness, after eating raw persimmon. A few months later he developed similar cutaneous symptoms accompanied by nausea, vomiting, abdominal colic, and hypotension immediately after the intake of banana. The prick-prick test with raw persimmon and banana were positive, as well as the serum specific IgE to the extract of these fruits. The ImmunoCAP ISAC_112i test demonstrated a positive specific IgE against Act d 2 (kiwi thaumatin), which is homologous to banana TLP (Mus a 4). Serum IgE inhibition test with "sponge" of Diospyros kaki ImmunoCAP (f301) showed partial inhibition (40%) of IgE to Act d 2. This raises the suspicion that a TLP is at least partially responsible for the referred sensitization. This patient is sensitized to Diospyros kaki and Musa acuminata. An anaphylactic reaction to consumed persimmon, presumably as a result from cross-allergy with banana thaumatin was diagnosed in our patient. Thaumatin has not been previously described as an allergen of persimmon with cross-reactivity with banana, and in vitro with Act d 2 (kiwi TLP).

A alergia ao caqui (Diospyros kaki ) tem sido raramente documentada, não sendo a composição antigênica da fruta totalmente conhecida. Proteínas semelhantes à taumatina (TLPs) foram descritas como alergênicos em pólens e várias frutas, como no kiwi e banana, mas não no caqui. Apresenta-se o caso de um doente de 22 anos, com rinite alérgica persistente moderadagrave, sensibilizado a ácaros do pó doméstico. O doente refere episódio de prurido na mucosa oral e canal auditivo, seguido de urticária generalizada, que rapidamente evoluiu para disfonia, dispneia e tontura, após ingestão de caqui. Poucos meses depois, desenvolveu sintomas cutâneos semelhantes, acompanhados de náuseas, vómitos, cólica abdominal e hipotensão imediatamente após ingestão de uma banana. O teste cutâneo por picada com caqui e banana em natureza foram positivos, bem como o doseamento de IgE específica. O teste ImmunoCAP ISAC_112i identificou a presença de IgE específica para Act d 2 (taumatina do kiwi), homóloga da TLP da banana (Mus a 4). O estudo de inibição ImmunoCAP ISAC com "esponja" de Diospyros kaki (f301) produziu uma inibição parcial (40%) da ligação de IgE a Act d 2, permitindo presumir que uma proteína semelhante à taumatina é, pelo menos, parcialmente responsável pela referida sensibilização. Este doente encontra-se sensibilizado a Diospyros kaki e Musa acuminata. Uma anafilaxia ao caqui ingerido, presumivelmente resultante de reatividade cruzada com a taumatina da banana foi diagnosticada. Não estão descritas na literatura TLPs como alergênicos do caqui com reatividade cruzada com a banana e com Act d 2 in vitro (TLP do kiwi).

Humans , Male , Young Adult , Diospyros , Musa , Eating , Rhinitis, Allergic , Fruit , Hypersensitivity , Anaphylaxis , Mites , Pruritus , Signs and Symptoms , Urticaria , Vomiting , Immunoglobulin E , Intradermal Tests , Allergens , Colic , Ear Canal , Mouth Mucosa , Nausea
Rev. Soc. Bras. Clín. Méd ; 19(2): 116-119, abr.-jun. 2021.
Article in Portuguese | LILACS | ID: biblio-1379284


A dor abdominal no paciente com lúpus eritematoso sistêmico tem amplo espectro clínico, variando desde condições inespecí- ficas, como diarreia e vômitos, até eventos de importante morbi- mortalidade, como o abdome agudo inflamatório e/ou perfura- tivo. A seguir, descreve-se um caso de paciente do sexo feminino, de 23 anos, internada por dor abdominal associada a vômitos e à diarreia crônica e progressiva. Foi diagnosticada com lúpus eritematoso sistêmico há 2 anos. Durante a internação, evoluiu com quadro de abdome agudo, e foi realizada tomografia compu- tadorizada de abdome, revelando importante edema de parede intestinal difuso. Isso, somado a alterações clínico-laboratoriais, permitiu o diagnóstico de enterite lúpica. Foi realizado tratamen- to conservador, com corticoterapia e terapia de suporte com correção de distúrbios eletrolíticos severos, sendo iniciado ciclo- fosfamida, com resolução dos sintomas gastrintestinais.

Abdominal pain in patients with systemic lupus erythematosus has a broad clinical spectrum, ranging from nonspecific symp- toms, such as diarrhea and vomiting, to events of significant morbidity and mortality, such as acute inflammatory and/or per- forating abdomen. This article describes a case of a 23-year-old female patient hospitalized for abdominal pain, associated with vomiting and progressive chronic diarrhea. She was diagnosed with systemic lupus erythematosus 2 years ago. During hospita- lization, the patient progressed with acute abdomen, and an ab- dominal computed tomography scan was performed, revealing major diffuse intestinal wall edema. This, added to clinical and laboratories alterations, allowed the diagnosis of lupus enteritis. A conservative treatment with corticotherapy and supportive therapy with correction of severe electrolyte disturbances were initiated, as well as the prescription of cyclophosphamide, with resolution of gastrointestinal symptoms.

Humans , Female , Young Adult , Enteritis/etiology , Lupus Erythematosus, Systemic/complications , Vomiting/etiology , Water-Electrolyte Imbalance/therapy , Tomography, X-Ray Computed , Abdominal Pain/etiology , Ultrasonography , Adrenal Cortex Hormones/therapeutic use , Rare Diseases/etiology , Diarrhea/etiology , Enteritis/diagnosis , Enteritis/drug therapy , Administration, Intravenous , Piperacillin, Tazobactam Drug Combination/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Anti-Bacterial Agents/therapeutic use
Säo Paulo med. j ; 139(2): 147-155, Mar.-Apr. 2021. tab
Article in English | LILACS | ID: biblio-1290231


ABSTRACT BACKGROUND: The Health-Related Quality of Life Questionnaire for Nausea and Vomiting of Pregnancy (NVPQOL) is a validated questionnaire assessing quality of life among pregnant women with nausea and vomiting. OBJECTIVE: To translate, cross-culturally adapt and evaluate the reliability of the NVPQOL. DESIGN AND SETTING: Observational cross-sectional study developed in a public university in Brazil. METHODS: The translation, synthesis of translations, back-translation, expert committee, pre-testing and validation were carried out, resulting in a Portuguese-language version. The internal consistency, intra-rater and test-retest reliability and correlation between the total score of the Portuguese-language version of the NVPQOL and the domains of the World Health Organization Quality of Life-bref questionnaire were considered in the data analysis. RESULTS: The instrument went through the process with testing on 104 pregnant women. Strong internal consistency (Cronbach's α: 0.95), strong intra-rater and test-retest reliability (P < 0.0; intraclass correlation coefficient: 0.89; confidence interval: 0.791-0.945) and strong correlation between the total score of the Portuguese-language version of the NVPQOL and the physical health domain of the World Health Organization Quality of Life-bref questionnaire (P < 0.01; R = −0.8) were observed. CONCLUSION: The NVPQOL was translated, cross-culturally adapted and validated for the Portuguese language with satisfactory psychometric properties for assessing quality of life, especially in relation to physical health, among pregnant women with symptoms of nausea and vomiting in the first trimester of pregnancy.

Humans , Female , Pregnancy , Quality of Life , Cross-Cultural Comparison , Psychometrics , Translations , Vomiting , Brazil , Cross-Sectional Studies , Surveys and Questionnaires , Reproducibility of Results , Nausea
Med. U.P.B ; 40(1): 77-81, 03/03/2021. Ilus
Article in Spanish | LILACS, COLNAL | ID: biblio-1177502


Los diferentes reportes de consumo de sustancias evidencian cómo el consumo de alcohol afecta diferentes órganos y sistemas; según el tiempo de presentación hay riesgos agudos y crónicos. Dentro de las complicaciones agudas gastrointestinales asociadas al consumo de alcohol está el síndrome de Boerhaave consistente en una ruptura esofágica espontánea. Es importante identificar este síndrome porque se relaciona con alta mortalidad debido a la amplia gama de signos y síntomas que produce, como vómito, disnea, taquipnea, taquicardia y dolor esternal, que pueden generar confusión con otras enfermedades como el tromboembolismo pulmonar. El objetivo de este reporte es pre-sentar el primer caso clínico en Colombia de un paciente con síndrome de Boerhaave como complicación del consumo de alcohol, ya que es importante que el personal de salud reconozca los factores de riesgo que lo desencadenan.

Numerous reports of substance use show how alcohol consumption affects different organs and systems; related risks can be acute and chronic, depending on the time of presentation. Among the acute gastrointestinal complications associated with alcohol consumption is Boerhaave syndrome, which consists of a spontaneous esophageal rupture. It is important to identify this pathology because it is associated with high mortality due to the wide range of signs and symptoms that it produces such as vomiting, dyspnea, tachypnea, tachycardia, and sternal pain, which can lead to confusion with other diseases like pulmonary thromboembolism and may therefore delay proper and timely diagnostic. The objective of this report is to present the first clinical case reported in Colombia of a patient who suffered from Boerhaave syndrome secondary to chronic alcohol consumption and to sensitize the health personnel about the importance of recognizing alcohol consumption as a risk factor for this complication.

Os diferentes relatos de uso de substâncias mostram como o consumo de álcool afeta diferentes órgãos e sistemas; dependendo da época de apresentação, existem riscos agudos e crônicos. Entre as complicações gastrointestinais agudas associadas ao con-sumo de álcool está a síndrome de Boerhaave, que consiste em uma ruptura esofágica espontânea. É importante identificar essa síndrome, pois está associada a alta mortalidade devido à ampla gama de sinais e sintomas que produz, como vômitos, dispneia, taquipneia, taquicardia e dor esternal, que podem levar à confusão com outras doenças, como tromboembolismo pulmonar. O objetivo deste relatório é apresentar o primeiro caso clínico na Colômbia de um paciente com síndrome de Boerhaave como uma complicação do consumo de álcool, pois é importante que o pessoal de saúde reconheça os fatores de risco que a desencadeiam.

Humans , Alcohol Drinking , Pain , Pulmonary Embolism , Rupture , Tachycardia , Vomiting , Confusion , Ethanol
Medicentro (Villa Clara) ; 25(1): 22-37, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1287180


RESUMEN Introducción: las náuseas y vómitos postoperatorios se sitúan como la peor experiencia del paciente junto al dolor y el despertar intraoperatorio. Objetivo: determinar la incidencia de náuseas y vómitos postoperatorios en pacientes que reciben anestesia general para cirugía electiva. Métodos: se realizó un estudio observacional, descriptivo, de corte transversal en 2 334 pacientes desde enero de 2013 a diciembre de 2018, en el Hospital Universitario Clínico-Quirúrgico Arnaldo Milián Castro y el Hospital Universitario Dr. Celestino Hernández Robau, de Santa Clara. Se estudiaron las variables: sexo, edad, tabaquismo, antecedentes de cinetosis, náuseas y vómitos postoperatorios, agentes anestésicos y halogenados empleados, uso de opiodes perioperatorios, tipo de intervención quirúrgica según estancia hospitalaria y tratamiento al sitio quirúrgico, tiempo quirúrgico y aparición de náuseas y vómitos en las primeras 24 horas del postoperatorio. Resultados: la incidencia de náuseas y vómitos postoperatorios fue de 15,9%, con predominio en el sexo femenino, en pacientes menores de 50 años de edad, los no fumadores, los que presentaban antecedentes de náuseas y vómitos postoperatorios o cinetosis, en los que se utilizó agentes halogenados y opiodes postoperatorios, en cirugía no ambulatoria y de enfoque convencional, y en los pacientes con tiempos quirúrgicos iguales o mayores a una hora. Conclusiones: la incidencia de náuseas y vómitos postoperatorios fue baja y se estableció una probabilidad de náuseas y vómitos postoperatorios desde ningún factor hasta 7 factores de riesgo de: 5,5 %, 6,9 %, 13,3 %, 29,7 %, 40 %, 50 %, 60 % y 71,4 %, respectivamente.

ABSTRACT Introduction: postoperative nausea and vomiting rank as the worst patient experience along with pain and intraoperative awakening. Objective: to determine the incidence of postoperative nausea and vomiting in patients who receive general anesthesia for elective surgery. Methods: an observational, descriptive, cross-sectional study was carried out in 2 334 patients belonging to "Arnaldo Milián Castro" Clinical and Surgical University Hospital and "Dr. Celestino Hernández Robau" University Hospital from Santa Clara between January 2013 and December 2018. Gender, age, smoking, history of motion sickness, postoperative nausea and vomiting, anesthetic and halogenated agents used, use of perioperative opioids, type of surgical intervention according to hospital stay and treatment at the surgical site, surgical time and appearance of nausea and vomiting in the first 24 hours after surgery were the variables studied. Results: the incidence of postoperative nausea and vomiting was 15.9%, with a predominance in female patients under 50 years of age, non-smokers, those with a history of postoperative nausea and vomiting or motion sickness, in which halogenated agents and postoperative opioids were used, in non-ambulatory surgery and conventional approach, and in patients with surgical times equal to or greater than one hour. Conclusions: the incidence of postoperative nausea and vomiting was low and a probability of postoperative nausea and vomiting was established from no factor to 7 risk factors with percentage values: 5.5%, 6.9%, 13.3%, 29.7%, 40%, 50%, 60% and 71.4%, respectively.

Postoperative Complications , Vomiting , Anesthesia, General , Nausea
Article in English | WPRIM | ID: wpr-922123


BACKGROUND@#The side effects of chemotherapy-induced nausea and vomiting (CINV) and myelosuppression reduce the cancer patients' adherence to chemotherapy. Many Chinese patients choose Chinese medicine (CM) during chemotherapy to reduce side effects; however, the evidence is lacking. The efficacy of a CM herbal treatment protocol, Jianpi Bushen Sequential Formula (, JBSF) will be evaluated on chemotherapy completion rate among patients with colon cancer.@*METHODS@#A multi-center double-blind randomized controlled trial (RCT) will be conducted on 400 patients with colon cancer who will receive 8 cycles of adjuvant chemotherapy with oxaliplatin and capecitabine (CAPEOX). Patients will be randomized 1:1 to receive the JBSF or placebo formula. The primary outcome is the overall chemotherapy completion rate. The secondary outcomes include individual chemotherapy completion rate, 4-cycle completion rate of chemotherapy, time to treatment failure, relative dose intensity and treatment toxicity. Follow-up visits will be scheduled before every and after last chemotherapy.@*DISCUSSION@#This study will provide evidence on whether JBSF can improve the chemotherapy completion rate and reduce side effects among patients with colon cancer. (Trial registration:, No. NCT03716518).

Chemotherapy, Adjuvant , Colonic Neoplasms/drug therapy , Double-Blind Method , Humans , Multicenter Studies as Topic , Nausea , Quality of Life , Randomized Controlled Trials as Topic , Treatment Outcome , Vomiting
J. Health Biol. Sci. (Online) ; 9(1): 1-15, 2021. ilus
Article in English | LILACS | ID: biblio-1370069


Aim: To describe and analyze the main disorders in the respiratory system, in individuals with confirmed cases of COVID - 19 reported in the scientific literature. Methods: Systematic literature review, based on the flowchart of the "Preferred Reporting Items for Systematic Reviews and Meta-Analyzes" (PRISMA), including primary quantitative experimental or quasi-experimental studies, freely accessible articles, available in Portuguese, English, Spanish and published from 2019 to 2020, using the PICOS strategy. 8,543 articles during March and April 2020, through the Lilacs, Scielo, Pubmed, MedLine, PeDro, Cochrane, Science direct and Google academic databases and of these, the Start tool (State-of-the-Art through Systematic Review) managed 94 studies. Results: Studies showed that most individuals had admission with signs and symptoms of fever, dry cough, difficulty breathing, expectoration, nausea, vomiting, diarrhea and rare myalgia. reaching from children to the elderly and had some previous comorbidities. Conclusion: This review identified the emphatic onset of the disease since symptoms and respiratory complications appear between 3 and 14 days.

Objetivo: Descrever e analisar as principais doenças do aparelho respiratório, em indivíduos com casos confirmados de COVID - 19 relatados na literatura científica. Métodos: Revisão sistemática da literatura, com base no fluxograma dos "Itens de Relatório Preferenciais para Revisões Sistemáticas e Meta-análises" (PRISMA), incluindo estudos quantitativos primários experimentais ou quase experimentais, artigos de livre acesso, disponíveis em português, inglês, espanhol e publicado de 2019 a 2020, utilizando a estratégia PICOS. 8.543 artigos durante os meses de março e abril de 2020, por meio das bases de dados Lilacs, Scielo, Pubmed, MedLine, PeDro, Cochrane, Science direct e Google Acadêmico e, destas, a ferramenta Start (State-of-the-Art through Systematic Review) geriu 94 estudos. Resultados: Estudos demonstraram que a maioria dos indivíduos apresentou internação com sinais e sintomas de febre, tosse seca, dificuldade respiratória, expectoração, náuseas, vômitos, diarreia e rara mialgia. atingindo desde crianças até idosos e com algumas comorbidades prévias. Conclusão: Esta revisão identificou o início enfático da doença, uma vez que os sintomas e complicações respiratórias aparecem entre 3 e 14 dias

Coronavirus , COVID-19 , Respiration , Respiratory System , Respiratory Tract Diseases , Vomiting , Health Strategies , Quality Indicators, Health Care , Cough
Rev. gaúch. enferm ; 42(spe): e20200205, 2021. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1251789


ABSTRACT Objective To identify symptoms of COVID-19 in adults in the scientific literature. Method Systematic review of studies published from December 1, 2019 to April 21, 2020 from the Scopus, Web of Science and PubMed databases, in order to answer the following research question: "What are the symptoms caused by COVID-19 in adults?" using the keywords "Symptoms", "Clinical Manifestations", "Coronavirus", "COVID-19". Results Of the total 105 references, 13 references that addressed the symptoms of COVID-19 were selected. Fever and normal or dry cough were symptoms present in all studies. Conclusion The symptoms identified in adult patients were fever, normal or dry cough, headache, pharyngalgia, dyspnea, diarrhea, myalgia, vomiting, sputum or expectoration, anxiety or chest pain, fatigue, nausea, anorexia, abdominal pain, rhinorrhea, runny nose or nasal congestion, dizziness, chills, systemic pain, mental confusion, hemoptysis, asthma, taste disorder, smell disorder, belching and tachycardia.

RESUMEN Objetivo Verificar en la literatura científica las manifestaciones sintomáticas de COVID-19 en adultos. Método Una revisión sistemática realizada en las bases de datos Scopus, Web of Science y PubMed con estudios publicados del 1 de diciembre de 2019 al 21 de abril de 2020, con el fin de responder a la pregunta orientadora: "¿Cuáles son las manifestaciones sintomáticas causada por COVID-19 en adultos?" utilizando las palabras clave: "Síntomas", "Manifestaciones clínicas", "Coronavirus", "COVID-19". Resultados Del total de 105 referencias, se seleccionaron 13 que abordaron las manifestaciones sintomáticas de COVID-19, con fiebre y tos normal o seca presente en todos los estudios. Conclusión Las manifestaciones sintomáticas identificadas en pacientes adultos fueron: fiebre, tos normal o seca, dolor de cabeza, faringalgia, disnea, diarrea, mialgia, vómitos, esputo o expectoración, angustia o dolor en el pecho, fatiga, náuseas, anorexia, dolor abdominal, rinorrea, secreción nasal o congestión nasal, mareos, escalofríos, dolor sistémico, confusión mental, hemoptisis, asma, alteración del gusto, alteración del olfato, eructos y taquicardia.

RESUMO Objetivo Verificar na literatura científica as manifestações sintomáticas da COVID-19 em pessoas adultas. Método Revisão sistemática utilizando as bases Scopus, Web of Science e PubMed com estudos publicados de 1 de dezembro de 2019 a 21 de abril de 2020, a fim de responder à questão norteadora: "Quais as manifestações sintomáticas causada pela COVID-19 em pessoas adultas?" utilizando-se as palavras-chave: "Symptoms", "Clinical Manifestations", "Coronavirus", "COVID-19". Resultados Do total de 105 referências, foram selecionadas 13 que abordaram as manifestações sintomáticas da COVID-19, estando a febre e a tosse normal ou seca presente em todos os estudos. Conclusão As manifestações sintomáticas identificadas nos pacientes adultos foram: febre, tosse normal ou seca, cefaleia, faringalgia, dispneia, diarreia, mialgia, vômito, escarro ou expectoração, angústia ou dor no peito, fadiga, náusea, anorexia, dor abdominal, rinorreia, coriza ou congestão nasal, tontura, calafrios, dor sistêmica, confusão mental, hemoptise, asma, comprometimento do paladar, comprometimento do olfato, arroto e taquicardia.

Humans , Male , Female , Adult , General Symptoms , SARS-CoV-2 , COVID-19 , Asthma , Vomiting , Anorexia , Databases, Bibliographic , Cough , Ageusia , Diarrhea , Dizziness , Fatigue , Fever , Olfaction Disorders
Rev. bras. epidemiol ; 24: e210036, 2021. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1288483


RESUMO: Objetivos: Analisar o perfil sociodemográfico e clínico dos pacientes atendidos pelo serviço de atendimento remoto "Telessaúde-COVID" e os fatores associados aos resultados positivos para COVID-19. Métodos: Estudo exploratório e analítico, realizado com base na análise dos registros de pacientes atendidos por um serviço de atendimento remoto intitulado "Telessaúde-COVID". Foram avaliadas características dos pacientes atendidos e variáveis relacionadas ao funcionamento do serviço. Realizou-se análise descritiva e inferencial, com utilização da regressão logística. Resultados: Foram avaliados 1.854 novos pacientes e estimados 8.630 atendimentos. Houve predomínio de pacientes do sexo feminino (60,9%) e da faixa etária de 20 a 59 anos (75,9%). Os sinais e sintomas mais frequentes foram: cefaleia (41,8%), tosse (33,3%) e coriza (30,0%). Do total de pacientes, 66,4% foram notificados como casos suspeitos de COVID-19 e 14,5% apresentaram resultado positivo para COVID-19. A idade igual ou superior a 60 anos foi mais frequente entre os casos confirmados (26,6%). A maioria dos pacientes (80,4%) não necessitou de atendimento presencial. Os resultados positivos para COVID-19 estiveram associados à idade dos pacientes (Odds Ratio - OR 1.020; intervalo de confiança - IC95% 1.007 - 1.032); contato domiciliar com caso positivo ou suspeito (OR 1.902; IC95% 1.178 - 3.070); presença de náuseas/vômitos (OR 2.403; IC95% 1.148 - 5.029) e alterações no olfato (OR 2.827; IC95% 1.294 - 6.176). Conclusões: O Telessaúde-COVID foi relevante na condução e notificação dos casos atendidos, evitando a procura por consultas presenciais sem indicação clínica. Entre os casos suspeitos, a positividade para COVID-19 associou-se a idosos, história de contato domiciliar, sintomas gastrointestinais e olfatórios.

ABSTRACT: Objective: to analyze the sociodemographic and clinical profile of patients treated by the remote care service "Telessaúde-COVID" and the factors associated with positive results for COVID-19. Methods: an exploratory and analytical study, carried out based on the analysis of patient records treated by a remote care service called "Telessaúde-COVID". Characteristics of the patients treated and variables related to the service's functioning were evaluated. A descriptive, inferential analysis was performed by logistic regression. Results: 1,854 new patients were evaluated and an estimate of 8,630 visits. Female patients were predominant (60.9%), aged between 20 and 59 years (75.9%). The most frequent signs and symptoms were: headache (41.8%), cough (33.3%) and runny nose (30.0%). Of the total number of patients, 66.4% were reported as suspected case of COVID-19 and 14.5% tested positive for COVID-19. The age of 60 years or more was more common among confirmed cases (26.6%). Most patients (80.4%) did not require face-to-face assistance. Confirmed cases of COVID-19 were associated with the age of the patients (OR 1,020; IC95% 1,007 - 1,032); home contact with a confirmed/suspected case (OR 1,902; IC95% 1,178 - 3,070); presence of nausea/vomiting (OR 2,403; IC95% 1,148 - 5,029) and changes in smell (OR 2,827; IC95% 1,294 - 6,176). Conclusion: "Telessaúde-COVID" was relevant in the management and notification of cases, avoiding the search for face-to-face consultations without clinical indication. Among the suspected cases, positivity for COVID-19 was associated with aging, history of home contact, gastrointestinal and olfactory symptoms.

Humans , Female , Adult , Middle Aged , Young Adult , COVID-19 , Vomiting , Brazil/epidemiology , SARS-CoV-2 , Headache