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3.
Med. clín (Ed. impr.) ; 153(11): 424-429, dic. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-186947

RESUMO

Introducción: Existen lagunas respecto a los niveles normativos de hemoglobina y la prevalencia de anemia en nuestro entorno y en determinados subgrupos de población. Objetivos: Examinar los valores medios de hemoglobina en una región española de orografía montañosa, según sexo, rango de edad y altitud de residencia, y la predicción de anemia según umbrales de la OMS y otras propuestas. Material y métodos: Estudio descriptivo transversal de todos los pacientes > 14 años del Sector Huesca con ≥ 1 analítica en los 5 años de inclusión; análisis multivariado para determinar la influencia de los factores demográficos en los valores de hemoglobina. Resultados: Se incluyeron 583.856 informes analíticos de 90.800 pacientes (cobertura 89,1%) residentes entre 281 y 1.305 metros de altitud: 54,6% mujeres; edad media 52,6 años. Hemoglobina media: 14,1 g/dl (hombres:15,0/mujeres:13,4). Prevalencia de anemia: 8,99% (hombres: 7,8%/mujeres: 10,0%). Resultó más frecuente en mujeres (1,6 veces), y aumentaba llamativamente con la edad: > 65 años: 16,5%; ≥ 75 años: 21,7%; ≥ 80 años: 25,7%; > 90 años: 35%. Aumentaba 1,02 veces por cada año, y 0,99 veces por cada metro de altitud. En residentes a ≥ 1.000 m, descendía a la mitad. Conclusiones: Se obtuvieron datos de subpoblaciones previamente poco descritas; la anemia en población mayor requiere consideración. La influencia de la altitud no parece suficientemente abordada con la corrección de la OMS. Se deben plantear estudios amplios para definir criterios apropiados para edades avanzadas y residentes en altura en España, pues ambos grupos constituyen una proporción importante, para evitar incurrir potencialmente en infradiagnóstico de anemia y supradiagnóstico de otras patologías


Introduction: There are gaps in our knowledge of the normative levels of haemoglobin and the prevalence of anaemia in our geographical area, and in certain population subgroups. Objectives: To study the mean values of haemoglobin in a mountainous Spanish region, according to sex, age range and residence altitude, and the prediction of anaemia according to the WHO thresholds and other proposals. Material and methods: Cross-sectional descriptive study of all patients aged >14 residents in the Huesca healthcare Sector with ≥1 laboratory report in the 5 years of inclusion; multivariate analysis to determine the influence of demographic factors on haemoglobin values. Results: 583,856 laboratory reports of 90,800 patients (coverage 89.1%) residing between 281 and 1305 meters: 54.6% female; mean age 52.6 years. Hb mean: 14.1 g/dl (males:15.0/females:13.4). Prevalence of anaemia: 8.99% (males: 7.8%/females:10.0%). It was more frequent in women (1.6 times) and increased markedly with age: >65 years:16.5%; ≥75 years: 21.7%; ≥80 years: 25.7%; >90 years 35%. It increased 1.02 times per year, and 0.99 times per meter of altitude. In residents ≥1000 m, anaemia prevalence fell by half. Conclusions: We obtained data from sub-populations that were previously not well described; anaemia in the elderly requires consideration. The influence of altitude does not seem to be fully considered within the correction framework proposed by WHO. Broader studies should be planned in order to obtain adequate parameters for the elderly and residents at high altitudes in Spain, as both groups represent an important proportion of the population, to avoid potential underdiagnosis of anaemia and overdiagnosis of other pathologies


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Anemia/epidemiologia , Altitude , Anemia/diagnóstico , Hemoglobinas/análise , Estudos Transversais , Análise Multivariada , Anemia/sangue , Biomarcadores/sangue
7.
Enferm. glob ; 18(56): 273-281, oct. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-188273

RESUMO

Objetivo: Determinar la asociación entre los factores sociodemográficos y prenatales con la anemia en gestantes peruanas. Método: Análisis secundario de la muestra ENDES 2017. La muestra fue de 639 gestantes entre 15 a 49 años. La variable dependiente fue la anemia ferropénica y las variables independientes fueron los factores sociodemográficos y prenatales. Para el análisis bivariado se calculó la Razón de prevalencia. Resultados: Respecto a los factores sociodemográficos y la anemia, las gestantes con un nivel educativo superior tienen menos posibilidad de presentar anemia (PR: 0,91; IC 95%: 0,42-1.96; p= 0,041). Por otro lado, entre los factores obstétricos y prenatales asociados a la anemia fueron: iniciar el control prenatal en el tercer mes (PR: 1,4; IC 95%: 0,74-1,58; p= 0,03) y encontrarse en el segundo trimestre de embarazo (PR: 1,35; IC 95%: 0,74-1,58; p= 0,04). Mientras que las gestantes que tienen más hijos (PR: 0,87; IC 95%: 0,78-0,97; p= 0,02) tienen menos posibilidad de presentar anemia. Conclusión: El nivel educativo superior y tener más hijos son factores protectores de la anemia. El inicio de control prenatal a partir del tercer mes y el segundo trimestre de gestación se asociaron con la presencia de anemia en las gestantes


Objective: To determine the association between sociodemographic and prenatal factors with anemia in Peruvian pregnant women. Method: Secondary analysis of the ENDES 2017 sample. The sample consisted of pregnant women between 15 and 49 years old. The dependent variable was iron deficiency anemia and the independent variables were sociodemographic and prenatal factors. For the bivariate analysis. prevalence ratio was calculated. Results: Regarding sociodemographic factors and anemia, pregnant women with a higher educational level have less possibility of presenting anemia (PR: 0,91; 95% CI: 0,42-1,96; p = 0,041). On the other hand, among the obstetric and prenatal factors associated with anemia were: initiate prenatal control in the third month (PR: 1,4; 95% CI: 0,74-1,58, p = 0,03) and be found in the second trimester of pregnancy ( PR: 1,35, 95% CI: 0,74-1,58; p = 0,04). While pregnant women who have more children (PR: 0,87; 95% CI: 0,78-0,97; p = 0,02) are less likely to have anemia. Conclusion: The higher educational level and having more children are protective factors of anemia. The start of prenatal control from the third month and the second trimester of pregnancy were associated with the presence of anemia in pregnant women


Assuntos
Humanos , Feminino , Gravidez , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Anemia/epidemiologia , Índices de Eritrócitos/fisiologia , Complicações na Gravidez/prevenção & controle , Educação em Saúde/métodos , Cuidados de Enfermagem/métodos , Anemia Ferropriva/diagnóstico , Peru/epidemiologia , Fenômenos Fisiológicos da Nutrição Pré-Natal , Anemia/prevenção & controle , Fatores de Risco , Paridade , Estudos Epidemiológicos
8.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 54(5): 272-0279, sept.-oct. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-192714

RESUMO

Background: Anaemia is a very common condition in elderly patients with hip fracture. The side effects of blood transfusions are well known, and further research on potential alternative therapies is needed. Objectives and design: A non-controlled descriptive study, conducted on 138 patients admitted for hip fracture, aimed at analysing the effects of an anaemia treatment protocol adjunctive to transfusion, based on the use of supra-physiological doses of intravenous iron and erythropoietin (IS/EPOS). The variables collected were, medical history, physical and cognitive status prior to fracture, as well as the need of blood products, medical complications during admission and their functional outcome at three and six months after the fracture were evaluated. Transfusion rates were compared with a historical control group when the only treatment for acute anaemia was transfusion (2011). Results: Almost half (63, 48%) of the patients received blood transfusion, with (91,70%) IS/EPOD. Intravenous iron did not reduce the percentage of transfused patients (56% vs. 44%), but it did reduce the number of blood units required (0.7 units less in IS/EPO group). Patients who required transfusion had a longer hospital stay, (1.7 days; 13.2 vs. 11.5; p<0.005). Patients who received IS had better functional recovery assessed with Barthel index and the Functional Ambulation Categories (FAC scale) at 3 and 6 months after the fracture. Patients with malnutrition or subtrochanteric fracture needed more tabletransfusions (p<0.005). Functional recovery at 3 and 6 months after fracture was better in patients who received intravenous iron. Neither blood transfusions nor intravenous iron were associated with infectious complications or increased mortality. The patient series of this study was compared with a group of patients with hip fracture and similar characteristics seen in 2011, before intravenous iron was available, revealing a 17% reduction in blood transfusion needs (p<0.005). Conclusion: The use of intravenous iron in elderly patients with hip fracture may help to reduce the number of blood units needed for the treatment of anaemia, although a causal relationship cannot be established due to not having a control group. Transfusions were associated with longer hospital stay in elderly patients with hip fracture


Introducción: El síndrome anémico es muy frecuente en el anciano ingresado por fractura de cadera. Los documentados efectos secundarios de la transfusión de hemoderivados hacen necesario investigar otras posibles alternativas terapéuticas. Material y métodos: Estudio descriptivo de 138 pacientes ingresados por fractura de cadera que evalúa el efecto de un protocolo de tratamiento de anemia perioperatoria complementario a transfusión, basado en el empleo de dosis suprafisiológicas de hierro intravenoso y eritropoyetina (FE/EPO). Se trata de un estudio descriptivo sin grupo control. Se evaluaron los antecedentes médicos de los pacientes, y su situación mental y física previas al ingreso, la necesidad de hemoderivados, las complicaciones en el ingreso y su evolución funcional en los 6 meses posteriores a la fractura. Los ratios de transfusión fueron comparados con los de una muestra histórica de similares características sin tratamiento con ferroterapia intravenosa (2011). Resultados: Recibieron transfusión el 48% de los pacientes (63) y ferroterapia parenteral con eritropoyetina (FE/EPO) el 70% (91). La administración de FE/EPO no disminuyó el porcentaje de pacientes hemotransfundidos (56 vs. 44%) de forma significativa, pero sí redujo el número de unidades de sangre requeridas (0,7 unidades menos en grupo de FE/EPO). Los pacientes que recibieron ferroterapia intravenosa tuvieron una estancia hospitalaria de 1,7 días inferior que los transfundidos (11,5 vs. 13,2; p<0,005). La administración de hierro parenteral se relacionó con tendencia a una mejor recuperación de capacidad de autocuidados y deambulación medidos mediante el índice de Barthel (IB) y la escala de deambulación de Holden (FAC) a los 3 y 6 meses de la fractura. La anemia y la malnutrición al ingreso, así como el tipo de fracturas subtrocantérea se relacionaron de forma independiente a mayor necesidad de transfusión (p<0,005). Ni las transfusiones ni el tratamiento con ferroterapia parenteral se asociaron a más complicaciones infecciosas ni a mayor mortalidad. Al comparar la muestra actual con un control histórico de pacientes con fractura de cadera sin disponibilidad de tratamiento con hierro intravenoso, se observa reducción actual del porcentaje de pacientes transfundidos en un 17% (p<0,005). Conclusión: El empleo de ferroterapia intravenosa en pacientes con fractura de cadera puede reducir el número de unidades de hemoderivados necesarias, sí bien no se puede establecerse una relación causal al no ser un estudio controlado. La transfusión se asocia con una prolongación de la estancia hospitalaria en el anciano ingresado por fractura de cadera


Assuntos
Humanos , Masculino , Feminino , Idoso de 80 Anos ou mais , Anemia/etiologia , Anemia/terapia , Transfusão de Sangue , Fraturas do Quadril/complicações , Protocolos Clínicos , Terapia Combinada , Resultado do Tratamento
10.
Rev. esp. nutr. comunitaria ; 25(3): 0-0, jul.-sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-191445

RESUMO

FUNDAMENTOS: La anemia infantil es un problema crítico en zonas altoandinas del Perú por su asociación con la morbi-mortalidad materno infantil e impacto negativo en el desarrollo emocional, cognitivo y motor de los niños. Se ha realizado un estudio para determinar la prevalencia de anemia en la población infantil del distrito de Tunanmarca y establecer su relación con factores socioeconómicos y productivos. MÉTODOS: Se encuestó a 48 familias campesinas del distrito de Tunanmarca. Se midió el contenido de hemoglobina de sus hijos menores de 5 años, previo consentimiento informado. Las asociaciones entre variables se determinaron con pruebas de Chi cuadrado y Rde Spearman, con un p<0,05 en el SPSS 23. RESULTADOS:La prevalencia de anemia infantil fue 86%, distribuidos en 34,9% de anemia leve, 46,5% de anemia moderada y 4,7% de anemia severa. Las prevalencias de enfermedades diarreicas y respiratorias agudas fueron 16,7 y 25%. La anemia infantil se asocia con algunas variables socioeconómicas y productivas. CONCLUSIONES: En la comunidad altoandina de Tunanmarca, Jauja-Perú se observó una alta prevalencia de anemia infantil, asociada inversamente con la educación materna, hogares adecuadamente constituidos, propietarios de la vivienda, mayor frecuencia de consumo de pescado, habas y crianza de animales domésticos


BACKGROUND: Infantile anemia is a critical problem in high Andean areas of Peru due to its association with maternal and infant morbidity and mortality and negative impact on the emotional, cognitive and motor development of children. A study was carried out to determine the prevalence of anemia in the child population of the Tunanmarca district and establish its relationship with socioeconomic and productive factors. METHODS: A survey to 48 peasant families of Tunanmarca district was applied, and the hemoglobin content of their children under 5 years old was measured, with prior informed consent. Associations between the variables were determined with Chi square tests and Spearman's R, with a p <0.05 in the SPSS 23. RESULTS:Infant anemia prevalence was 86%, distributed in 34.9% mild anemia, 46.5% moderate anemia and 4.7% severe anemia. Prevalence of diarrheal and acute respiratory diseases were 16.7 and 25%. Infant anemia prevalence is associated with some socioeconomic and productive variables. CONCLUSIONS: In the high Andean community of Tunanmarca, Jauja-Peru a high prevalence of childhood anemia was observed, inversely associated with maternal education, adequately constituted households, owning the home, with the highest frequency of consumption of fish, beans and the raising of domestic animals


Assuntos
Humanos , Masculino , Feminino , Lactente , Pré-Escolar , Adulto Jovem , Adulto , Anemia/epidemiologia , Produção de Alimentos , Abastecimento de Alimentos/classificação , Comportamento Alimentar/classificação , Peru/epidemiologia , Fatores Socioeconômicos , Indicadores de Morbimortalidade , Segurança Alimentar e Nutricional , Ecossistema Andino , Transtornos da Nutrição Infantil/epidemiologia , Transtornos da Nutrição do Lactente/epidemiologia , Agroindústria/estatística & dados numéricos , Características da Família/etnologia
12.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 54(4): 189-194, jul.-ago. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-191167

RESUMO

Antecedentes y objetivos: La prevalencia de anemia es un importante indicador sanitario, a pesar de lo cual en nuestro país hay poca información rigurosa recopilada al respecto en población anciana, especialmente en mayores de 80 años. De forma habitual se utiliza el mismo criterio para definir anemia en población anciana que en población general, aunque los datos epidemiológicos recogidos por la OMS en 1968, sobre la base de los cuales se generalizó dicho criterio, no incluían a mayores de 65 años. Nos planteamos dos objetivos. Por un lado, realizar una revisión crítica sobre si la validez del criterio usado para definir anemia en población adulta es extrapolable al adulto anciano. Por otro, revisar las publicaciones sobre prevalencia de anemia en ancianos mayores de 80 años. Material y métodos: Búsqueda bibliográfica sistemática sobre los objetivos planteados. Resultados: Aunque se utiliza de forma generalizada los criterios basados en datos de la OMS de 1968, diferentes autores han propuesto otros valores diagnósticos para población anciana. Hemos encontrado 20 estudios, realizados en Norteamérica y Europa, con solo 70.000 pacientes, y criterios de edad dispares. La prevalencia de la anemia oscila en estos estudios entre el 3 y el 63%, dependiendo del criterio diagnóstico utilizado, los rangos de edad estudiados y si eran institucionalizados o no. Conclusiones: La anemia es un enfermedad muy prevalente en pacientes de edad avanzada. Es necesaria la recogida de bases de datos amplias de población anciana para determinar unos criterios diagnósticos más adecuados


Background and objectives: The prevalence of anaemia is an important health indicator, although there is little rigorous information gathered on the elderly population, particularly in those over 80 years old. The same criteria that are used in the general population are often used to define anaemia in the elderly. The epidemiological data collected by the WHO in 1968 (that have been used to generalise this criteria), did not include the population over 65 years-old. Two objectives are established, which includes a critical review of the available evidence on whether the criteria used to define anaemia in the adult population can be extrapolated to the elderly, and a review of publications on the prevalence of anaemia in the elderly over 80 years-old. Material and methods: A systematic bibliographic search was performed on the established objectives. Results: Although the WHO criteria, based on data from 1968, are widely used, other possible cut-off points have been proposed for elderly people. A total of 20 studies were found that were conducted in North America and Europe, with only 70,000 patients, and different age criteria. The prevalence of anaemia ranges between 3% and 63%, depending on the diagnostic criteria, age, and whether they were institutionalised or not. Conclusions: Anaemia is a very prevalent disease in elderly patients. The collection of large databases is necessary to determine more adequate diagnostic criteria


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Anemia/diagnóstico , Anemia/epidemiologia , Hemoglobina A/análise , Fatores Etários , Anemia/sangue , Prevalência , Valores de Referência , Fatores Sexuais
13.
Rev. esp. enferm. dig ; 111(8): 643-647, ago. 2019. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-190339

RESUMO

Blue rubber bleb nevus syndrome (BRBNS) is a rare disorder with characteristic skin hemangiomas and vascular malformations, mostly in the gastrointestinal (GI) tract. The GI lesions are mainly located in the stomach and small intestine, usually more than a hundred, leading to gastrointestinal bleeding and severe chronic anemia. Parenteral iron infusions and scheduled transfusions are frequently necessary. We describe the case of a 21-year-old male with anemia secondary to BRBNS, who becomes unresponsive to octreotide and shows an excellent response to sirolimus (SRL), dismissing the intravenous iron supplementations and being free of transfusions. During the treatment, the patient presents avascular hip necrosis, which is adequately treated with an injection of stem cells with complete recovery, and without the suspension of SRL. Two years later, adequate response persists with no other relevant side effects


No disponible


Assuntos
Humanos , Masculino , Adulto Jovem , Anemia/tratamento farmacológico , Sirolimo/uso terapêutico , Síndrome do Nevo Displásico/complicações , Nevo Azul/complicações , Hemorragia Gastrointestinal/etiologia , Hemangioma/complicações
14.
Rev. esp. anestesiol. reanim ; 66(6): 315-323, jun.-jul. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-187540

RESUMO

Introducción: El proyecto Maturity Assessment Model in Patient Blood Management consiste en la aplicación de una matriz que evalúa la madurez del centro sobre la adecuación de su práctica transfusional. Esta herramienta incluye una encuesta dirigida a los profesionales sobre el grado de conocimiento del Patient Blood Management en su centro. Material y métodos: Durante 2016, 41 hospitales estuvieron asociados al proyecto Maturity Assessment Model in Patient Blood Management. La encuesta constaba de 10 preguntas, 3 sobre centro, especialidad y años de experiencia, y 7 sobre el conocimiento del Patient Blood Management. El número mínimo de respuestas por centro fue asignado según el número de camas. Se requería de un mínimo de respuestas de al menos 3 especialidades diferentes para poder ser evaluado. Resultados: El total de encuestas contestadas fue de 1403. La especialidad de mayor respuesta fue anestesiología (40,9%). La distribución respecto a experiencia profesional fue:<10 años 33,4%, 10-20 años 33% y >20 años 33,6%. Un 74,2% conocía el programa Patient Blood Management en su centro y un 60,7% conocía el protocolo de tratamiento de la anemia preoperatoria. El 72% refería conocer el protocolo de transfusión sanguínea de su centro y un 90% consideraba otros factores además del valor de la hemoglobina para la decisión de transfusión. Solo un 30,7% de los profesionales afirmó recibir información periódica sobre la práctica transfusional. Conclusiones: Se observó una falta significativa de conocimiento sobre los protocolos de tratamiento de la anemia y el protocolo transfusional de sus centros. En la actualidad pocos centros comunican datos sobre práctica transfusional


Introduction: The Maturity Assessment Model in Patient Blood Management project involves the use of a matrix that evaluates the maturity of the centre as regards blood transfusion practice. This tool includes a questionnaire to be completed by physicians to determine their level of knowledge of patient blood management strategies in their centre. Material and methods: Forty one hospitals took part in the Maturity Assessment Model in Patient Blood Management project in 2016. The questionnaire included 10 questions, 3 about the centre, specialty, and years of experience, and 7 about patient blood management protocols in the respondent's centre. The minimum responses required per centre was calculated according to the number of beds. Responses from at least 3 different specialties were required in order to be evaluated. Results: A total of 1403 questionnaires were completed. The specialty with the highest completion rate was anaesthesiology (40.9%). The distribution as regards professional experience was homogeneous: <10 years, 33.4%, 10-20 years, 33%, and> 20 years 33.6%. Nearly three-quarters (74.2%) knew the patient blood management protocol used in their centre, and 60.7% knew the protocol for the treatment of pre-operative anaemia. Slightly fewer (72%) reported knowing the blood transfusion protocol (transfusion threshold) used in their centre, and 90% considered other factors besides haemoglobin in the decision to transfuse. Only 30.7% of professionals reported receiving periodic information on transfusion practices. Conclusions: There is a significant lack of knowledge about preoperative anaemia and perioperative transfusion protocols used in the centres polled. Few centres provide their physicians with information on transfusion practices


Assuntos
Humanos , Transfusão de Sangue/normas , Competência Clínica/estatística & dados numéricos , Anemia/terapia , Medicina Transfusional/tendências , Perda Sanguínea Cirúrgica/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Manejo de Espécimes/normas , Protocolos Clínicos , Segurança do Sangue/estatística & dados numéricos , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos
17.
Pharm. pract. (Granada, Internet) ; 17(1): 0-0, ene.-mar. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184616

RESUMO

Background: Patients with heart failure often have comorbidities that alter the progression of heart failure and impact on prognosis. One such comorbidity is anaemia, and clinicians have started to appreciate the full gravity of its impact on heart failure patients. Yet, the extent of the problem is not fully understood, particularly the role of heart failure therapy itself as a risk factor for developing anaemia. Objective: This study aimed to investigate the prevalence of anaemia in a cohort of heart failure patients. The impact of using different ACEIs and different doses of aspirin was also explored, together with the prevalence of haematinic deficiencies. Methods: Medication lists and pathology results were examined to establish the prevalence of ACEIs use, and the use of aspirin at its most common doses of 100mg and 150mg, together with haematinic deficiencies. Multinomial logistic regression and the Student's t-test were utilised for the analysis of data. Statistical significance was pre-set at p<0.05. Results: Ninety-six patients were eligible for analysis, with 26% having anaemia. The use of ACEIs had a RR of 17.4 for the presence of anaemia. Perindopril was associated with a RR of 20.8, while the use of ramipril was not significantly associated with such a high RR. Haematinic anaemia occurred only at a rate of 3.3%, but borderline deficiencies were found in more than a third of all patients. An aspirin dose of 150mg was associated with a higher risk for anaemia, compared to a dose of 100mg. Conclusions: ACEIs are associated with the presence of anaemia, with perindopril posing more risk than ramipril when used in heart failure patients. The dose of aspirin may also be a factor in the development of anaemia, with lower doses being safer. Despite the lack of high prevalence of haematinic anaemia among this cohort of patients, borderline haematinic deficiencies were common


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Anemia/epidemiologia , Insuficiência Cardíaca/complicações , Inibidores da Enzima Conversora de Angiotensina/efeitos adversos , Aspirina/efeitos adversos , Anemia/etiologia , Insuficiência Cardíaca/tratamento farmacológico , Fatores de Risco , Estudos Retrospectivos
18.
Enferm. clín. (Ed. impr.) ; 29(supl.1): 94-97, mar. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184782

RESUMO

Low birthweight is one of the risk factors that contribute to infant mortality especially during perinatal period. Low birthweight is still a worldwide problem because it is a newborn's death. in essence many factors that affect the incidence of low birthweight they are maternal age and anemia. The purpose of this study is to analyze the maternal age and anemia are risk factors of low birthweight newborn. This research is an analytic observational study with case control study. The sample of this study amounted to 32 cases and 32 controls. The instrument used observation sheet by looking at the data in Medical Record. The analysis used is bivariate with person chi-square test to see the maternal age and anemia are risk factors of low birthweight newborn. The result of this study proved maternal age affect as low birthweight newborn, evidenced by statistic analysis p-value < 0.05 is 0.001 and Odd Ratio: 16.2 (Confident Interval 95%: 1.94-135.38), and anemia affect as low birthweight newborn, evidenced by statistic analysis p-value < 0.05 is 0.001 and Odd Ratio: 6.3 (Confident Interval 95%: 3-13.198). The results of this study can be concluded that maternal age and anemia have affect of low birthweight newborn


No disponible


Assuntos
Humanos , Gravidez , Recém-Nascido , Adulto Jovem , Adulto , Anemia/epidemiologia , Recém-Nascido de Baixo Peso , Idade Materna , Complicações Hematológicas na Gravidez/epidemiologia , Estudos de Casos e Controles , Fatores de Risco
20.
Gastroenterol. hepatol. (Ed. impr.) ; 42(3): 164-170, mar. 2019. graf, tab
Artigo em Inglês | IBECS | ID: ibc-182131

RESUMO

Introduction: In the interferon era, the treatment of hepatitis C virus (HCV) infection in patients on haemodialysis (HD) was limited due to the significant number of treatment-related adverse events (AEs). Direct-acting antivirals (DAAs) have demonstrated their efficacy and safety in the treatment of HCV in patients with advanced chronic kidney disease on haemodialysis. The objective of the study was to evaluate the success in eliminating HCV infection from our dialysis unit using DAAs, and to assess the impact of HCV elimination on clinical and analytical outcomes. Patients and methods: This is a prospective, interventional, single-center study at Hospital Clínic de Barcelona. All HCV-RNA positive patients who received antiviral therapy with DAAs within a 3-year period (2014-2017) were analyzed (n=20). Data on virologic response, adverse events, and biochemical and hematological parameters during and after DAA therapy were analyzed. Results: All patients achieved sustained virologic response (SVR) and only 40% of patients presented with mild AEs. None of the patients presented with HCV reinfection after a 1-year follow-up period, and thus HCV was eliminated from our HD unit. SVR was associated with a significant increase in hemoglobin and hematocrit, and a tendency toward the need for lower doses of iron supplementation with no changes in darbepoetin dose. Conclusion: HCV infection can be safely eliminated from HD units with the use of DAAs, preventing new infections in patients and healthcare staff. In the short term, the achievement of SVR is associated with an improvement in the control of anemia


Introducción: En la época del interferón, el tratamiento del virus de la hepatitis C (VHC) en pacientes en hemodiálisis (HD) se veía limitado por la presencia de efectos adversos relacionados con el tratamiento. Los agentes antivirales directos (AAD) han demostrado ser seguros y eficaces en el tratamiento del VHC en pacientes con insuficiencia renal crónica en hemodiálisis. El objetivo del estudio fue evaluar el éxito en eliminar la infección por VHC de nuestra unidad de diálisis con el uso de AAD, y determinar el impacto clínico y analítico de la curación de la infección. Pacientes y métodos: Para ello se realizó un estudio prospectivo de intervención en el Hospital Clinic de Barcelona y su centro de diálisis. Se incluyeron todos los pacientes (n=20) con ARN-VHC positivo que recibieron tratamiento antiviral con AAD durante un periodo de 3 años (2014-2017). Se analizaron los datos de respuesta virológica, efectos adversos y parámetros hematológicos y bioquímicos durante y después del tratamiento. Resultados: Todos los pacientes alcanzaron una respuesta viral sostenida (RVS) y solo una 40% presentaron efectos adversos leves. Ningún paciente presentó reinfección por el VHC y por ello tras un año de seguimiento se consideró la eliminación del VHC de nuestra unidad de diálisis. La RVS se asoció con aumento significativo de la hemoglobina y el hematocrito, y una tendencia a la necesidad de una dosis más baja de suplemento de hierro sin cambios en la dosis de darbepoetina. Conclusión: Con la utilización de AAD, la infección por el VHC puede ser eliminada de forma segura de las unidades de diálisis, previniendo la transmisión de la infección a pacientes y personal sanitario. A corto plazo, la RVS se asoció con una mejoría en el control de la anemia


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Hepatite C/terapia , Anemia/terapia , Antivirais/administração & dosagem , Resposta Viral Sustentada , Resultado do Tratamento , Anemia/prevenção & controle , Unidades Hospitalares de Hemodiálise , Estudos Prospectivos , Antivirais/efeitos adversos
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