ABSTRACT
OBJECTIVE: Intestinal intussusception (II) is a common cause for acute abdomen in children, occurring in 0.33 to 0.71 per 1000 children per year. Early diagnosis and treatment are fundamental for prevention of irreversible intestinal damage. The first line of treatment is conservative, with saline reduction enema or air reduction enema. Our goal is to evaluate results with conservative treatment of II in children. METHODS: A retrospective single-center review of all patients with diagnosis of II from January 2014 to December 2019 was performed. Demographics, clinical data, treatment option, and results were assessed. RESULTS: Thirty-eight cases were identified. The mean age was 26 months, and 68% were males. Most presented with abdominal pain (95%) and vomiting (66%), after an average of 30 hours. Rectal bleeding was present in 32% of patients. Abdominal ultrasound was performed in all patients for diagnosis. Conservative treatment was first option in 95% of patients, with a global effectiveness of 83% after 1 attempt. Saline reduction enema was more effective than air reduction enema (88% vs 70%), and patients with successful reduction were younger (24 vs 33 months), but neither reached statistical significance. Two patients had a subsequent II episode within 1 week after hospital discharge. Neither age, sex, symptoms and respective duration, rotavirus inoculation, intussuscepted bowel length, nor technique used was predictive of treatment failure or II relapse. CONCLUSIONS: Conservative treatment in II is a safe and effective option, preventing invasive surgical procedures. Effectiveness of such treatments may be as high as 88% after 1 attempt, with rapid diet reintroduction. Same-day discharge after oral feeding toleration is safe.
Subject(s)
Intussusception , Child , Male , Humans , Infant , Child, Preschool , Female , Retrospective Studies , Treatment Outcome , Intussusception/diagnosis , Conservative Treatment , Treatment Failure , Enema/methodsABSTRACT
Background Epidemiologic studies, including trials, suggest an association between potassium intake and blood pressure (BP). However, the strength and shape of this relationship is uncertain. Methods and Results We performed a meta-analysis to explore the dose-response relationship between potassium supplementation and BP in randomized-controlled trials with a duration ≥4 weeks using the recently developed 1-stage cubic spline regression model. This model allows use of trials with at least 2 exposure categories. We identified 32 eligible trials. Most were conducted in adults with hypertension using a crossover design and potassium supplementation doses that ranged from 30 to 140 mmol/d. We observed a U-shaped relationship between 24-hour active and control arm differences in potassium excretion and BP levels, with weakening of the BP reduction effect above differences of 30 mmol/d and a BP increase above differences ≈80 mmol/d. Achieved potassium excretion analysis also identified a U-shaped relationship. The BP-lowering effects of potassium supplementation were stronger in participants with hypertension and at higher levels of sodium intake. The BP increase with high potassium excretion was noted in participants with antihypertensive drug-treated hypertension but not in their untreated counterparts. Conclusions We identified a nonlinear relationship between potassium intake and both systolic and diastolic BP, although estimates for BP effects of high potassium intakes should be interpreted with caution because of limited availability of trials. Our findings indicate an adequate intake of potassium is desirable to achieve a lower BP level but suggest excessive potassium supplementation should be avoided, particularly in specific subgroups.
Subject(s)
Antihypertensive Agents/therapeutic use , Blood Pressure/drug effects , Dietary Supplements , Hypertension/drug therapy , Potassium Deficiency/drug therapy , Potassium, Dietary/administration & dosage , Adolescent , Adult , Aged , Antihypertensive Agents/adverse effects , Dietary Supplements/adverse effects , Female , Humans , Hypertension/epidemiology , Hypertension/physiopathology , Male , Middle Aged , Potassium Deficiency/epidemiology , Potassium Deficiency/physiopathology , Potassium, Dietary/adverse effects , Randomized Controlled Trials as Topic , Recommended Dietary Allowances , Risk Assessment , Risk Factors , Treatment Outcome , Young AdultABSTRACT
A ginástica laboral (GL) consiste em exercícios específicos de alongamento e relaxamento, atuando de forma preventiva e terapêutica entre os trabalhadores. Uma das classes mais acometidas pela dor muscular é o auxiliar de produção, com o principal movimento de preensão palmar. O objetivo deste estudo consistiu em verificar registros de queixas musculares no serviço de saúde da fábrica, e avaliar a força de preensão palmar após a realização da GL, nos auxiliares de produção. A amostra foi constituída por 55 trabalhadores, divididos aleatoriamente em 2 grupos: grupo teste (GT) com n = 28, submetidos a 45 sessões de GL, e um grupo controle (GC), n = 27, não realizando nenhuma intervenção. Na coleta de dados utilizou-se a dinamometria de preensão palmar, e o número de registros de queixas musculares em ambos os grupos. Verificou-se, uma redução de 26,25 por cento no número de queixas de dores musculares no GT em relação ao GC. Na dinamometria, foi observado um aumento significativo de 4,78 Kgf (p = 0,0042) na mão direita, e 4,84 (p = 0,0077) na mão esquerda após a GL realizada pelo GT, quando comparada com o GC. A GL, quando aplicada de forma adequada, regularmente e associada à ergonomia, pode ser eficaz na prevenção das doenças e dores musculares ocupacionais.
The stretching-break (SB) consists in specific stretching and relaxing exercises, acting as a preventive and therapeutic measure among workers. The auxiliary workers of the production department are frequently reporting muscle pain, with the main movement of hand grip. The aim of this study was to verify muscle complains registration at the factory health service and to evaluate the hand grip force after stretching-break of auxiliary workers of production. The sample was composed by 55 workers, randomly divided into 2 groups: test group (TG) with n = 28 took 45 sessions of stretching-break and the control group (CG), n = 27, did not have any intervention. During data collection, it was used the dynamometer for hand grip and the number of muscles complains records in both groups. It was noticed a reduction of 26.25 percent in the muscles pain complains in the TG compared to the CG. In the dynamometer it was observed a significant increase of 4.78 Kgf (p = 0.0042) in the right hand and 4.84 (p = 0.0077) in the left hand after the stretching-break of the TG, when compared to the CC. The SB when performed correctly and regularly associated to ergonomics can be efficient to prevent occupational diseases and muscles pain.