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1.
Gene ; 766: 145127, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-32937184

RESUMEN

Telomeres are duplex tandem repeats of DNA sequence 5'-TTAGGG-3' at chromosomal ends synthesized by telomerase enzyme (TE). Telomeres length (TL) shortening is associated with age and age-related disorders. Recently, we demonstrated marked leukocytes TL (LTL) shortening in T2DM. To set the relationship between the TE, LTL and T2DM, we analyzed samples from 212 Kuwaiti subjects, 112 patients withT2DM and 100 non-diabetic subjects. The plasma TE and fasting insulin were measured by ELISA, the LTL was estimated by qPCR and three SNPs of genes related to TL; TERC rs12696304 (C/G), TERT rs2736100 (C/A) and ACYP2 rs6713088 (C/G) were genotyped by rtPCR. Results revealed comparable TE levels and alleles/genotypes between the cases and controls with no influence of either on the LTL. Interestingly, although the plasma concentration of the TE was generally low, it was significantly influenced by the TERT and ACYP2 but not TERC polymorphisms. The CC genotype carriers of rs2736100 (C/A) had significantly higher plasma TE levels compared to CA and AA carriers, p 0.009 and p 0.047, respectively, and the A-allele was associated with low TE, p 0.018. Similarly, significantly higher TE levels were detected in CC carriers of ACYP2 rs6713088 (C/G) compared with GC carriers, p 0.002, and the G-allele was associated with low TE, p 0.009. Finally, the TERT and ACYP2 polymorphisms had an influence on blood glucose levels. In conclusion, the telomeres shortening in T2DM was not due to TE deficiency or gene polymorphisms, while the TE levels were significantly associated with the TERT and ACYP2 but not TERC polymorphisms.


Asunto(s)
Ácido Anhídrido Hidrolasas/genética , Diabetes Mellitus Tipo 2/genética , Polimorfismo de Nucleótido Simple/genética , ARN/genética , Telomerasa/genética , Acortamiento del Telómero/genética , Adulto , Anciano , Anciano de 80 o más Años , Alelos , Femenino , Predisposición Genética a la Enfermedad/genética , Genotipo , Humanos , Masculino , Persona de Mediana Edad , Telomerasa/sangre
2.
Ann Med ; 53(1): 103-116, 2021 12.
Artículo en Inglés | MEDLINE | ID: mdl-33063540

RESUMEN

BACKGROUND: Hyperglycaemia has emerged as an important risk factor for death in coronavirus disease 2019 (COVID-19). The aim of this study was to evaluate the association between blood glucose (BG) levels and in-hospital mortality in non-critically patients hospitalized with COVID-19. METHODS: This is a retrospective multi-centre study involving patients hospitalized in Spain. Patients were categorized into three groups according to admission BG levels: <140 mg/dL, 140-180 mg/dL and >180 mg/dL. The primary endpoint was all-cause in-hospital mortality. RESULTS: Of the 11,312 patients, only 2128 (18.9%) had diabetes and 2289 (20.4%) died during hospitalization. The in-hospital mortality rates were 15.7% (<140 mg/dL), 33.7% (140-180 mg) and 41.1% (>180 mg/dL), p<.001. The cumulative probability of mortality was significantly higher in patients with hyperglycaemia compared to patients with normoglycaemia (log rank, p<.001), independently of pre-existing diabetes. Hyperglycaemia (after adjusting for age, diabetes, hypertension and other confounding factors) was an independent risk factor of mortality (BG >180 mg/dL: HR 1.50; 95% confidence interval (CI): 1.31-1.73) (BG 140-180 mg/dL; HR 1.48; 95%CI: 1.29-1.70). Hyperglycaemia was also associated with requirement for mechanical ventilation, intensive care unit (ICU) admission and mortality. CONCLUSIONS: Admission hyperglycaemia is a strong predictor of all-cause mortality in non-critically hospitalized COVID-19 patients regardless of prior history of diabetes. KEY MESSAGE Admission hyperglycaemia is a stronger and independent risk factor for mortality in COVID-19. Screening for hyperglycaemia, in patients without diabetes, and early treatment of hyperglycaemia should be mandatory in the management of patients hospitalized with COVID-19. Admission hyperglycaemia should not be overlooked in all patients regardless prior history of diabetes.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Hiperglucemia/complicaciones , Neumonía Viral/mortalidad , Sistema de Registros , Anciano , Anciano de 80 o más Años , Glucemia , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/complicaciones , Cuidados Críticos/estadística & datos numéricos , Femenino , Humanos , Hiperglucemia/mortalidad , Tiempo de Internación , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/sangre , Neumonía Viral/complicaciones , Respiración Artificial/estadística & datos numéricos , España/epidemiología
3.
Gene ; 764: 145099, 2021 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-32861879

RESUMEN

Down syndrome (DS, trisomy 21) is the most common major chromosomal aneuploidy compatible with life. The additional whole or partial copy of chromosome 21 results in genome-wide imbalances that drive the complex pathobiology of DS. Differential DNA methylation in the context of trisomy 21 may contribute to the variable architecture of the DS phenotype. The goal of this study was to examine the genomic DNA methylation landscape in myocardial tissue from non-fetal individuals with DS. >480,000 unique CpG sites were interrogated in myocardial DNA samples from individuals with (n = 12) and without DS (n = 12) using DNA methylation arrays. A total of 93 highly differentially methylated CpG sites and 16 differentially methylated regions were identified in myocardial DNA from subjects with DS. There were 18 differentially methylated CpG sites in chromosome 21, including 5 highly differentially methylated sites. A CpG site in the RUNX1 locus was differentially methylated in DS myocardium, and linear regression suggests that donors' age, gender, DS status, and RUNX1 methylation may contribute up to ~51% of the variability in RUNX1 mRNA expression. In DS myocardium, only 58% of the genes overlapping with differentially methylated regions codify for proteins with known functions and 24% are non-coding RNAs. This study provides an initial snapshot on the extent of genome-wide differential methylation in myocardial tissue from persons with DS.


Asunto(s)
Islas de CpG/genética , Metilación de ADN , Síndrome de Down/genética , Epigénesis Genética , Miocardio/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Niño , Cromosomas Humanos Par 21/genética , Subunidad alfa 2 del Factor de Unión al Sitio Principal/genética , Epigenómica , Femenino , Sitios Genéticos/genética , Humanos , Lactante , Masculino , Persona de Mediana Edad , ARN Mensajero/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Análisis de Secuencia de ADN , Adulto Joven
4.
Crit Care Clin ; 37(1): 175-190, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33190768

RESUMEN

Older adults are particularly vulnerable during the Coronavirus disease 2019 (COVID-19) pandemic, because higher age increases risk for both delirium and COVID-19-related death. Despite the health care system limitations and the clinical challenges of the pandemic, delirium screening and management remains an evidence-based cornerstone of critical care. This article discusses practical recommendations for delirium screening in the COVID-19 pandemic era, tips for training health care workers in delirium screening, validated tools for detecting delirium in critically ill older adults, and approaches to special populations of older adults (eg, sensory impairment, dementia, acute neurologic injury).


Asunto(s)
Infecciones por Coronavirus/complicaciones , Delirio/complicaciones , Delirio/diagnóstico , Demencia/complicaciones , Neumonía Viral/complicaciones , Anciano , Anciano de 80 o más Años , Betacoronavirus , Delirio/prevención & control , Pérdida Auditiva/complicaciones , Humanos , Unidades de Cuidados Intensivos , Pandemias , Grupo de Atención al Paciente , Trastornos de la Visión/complicaciones
5.
J Infect Chemother ; 27(1): 94-98, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32988730

RESUMEN

The effect of systemic corticosteroids on clinical outcomes in patients with coronavirus disease 2019 (COVID-19) remains controversial. While the use of corticosteroids raises concerns regarding delayed viral clearance, secondary infections, and long-term complications that can lead to increased mortality, corticosteroids have the potential to reduce mortality if used appropriately. Herein, we report good outcomes in two patients with COVID-19 who received systemic corticosteroids as adjunctive therapy. An 83-year-old man with hypertension and smoking history and a 62-year-old man with a drinking habit were transferred to our hospital with a diagnosis of COVID-19. The patients developed general malaise and loss of appetite with persistent high fever. Despite the prescription of antiviral drugs, their hypoxemia progressed rapidly. However, after the introduction of systemic corticosteroids, their symptoms improved as the fever decreased, and their hypoxemia gradually improved. These results suggest that some patients with COVID-19 may benefit from the appropriate use of systemic corticosteroids as adjunctive therapy.


Asunto(s)
Corticoesteroides/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Metilprednisolona/uso terapéutico , Neumonía Viral/tratamiento farmacológico , Anciano de 80 o más Años , Consumo de Bebidas Alcohólicas/epidemiología , Antivirales/uso terapéutico , Betacoronavirus , Terapia Combinada , Infecciones por Coronavirus/epidemiología , Humanos , Hipertensión/epidemiología , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/epidemiología , Fumar/epidemiología , Neoplasias Gástricas/epidemiología , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
6.
J Infect Chemother ; 27(1): 117-119, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32994136

RESUMEN

The novel coronavirus disease 2019 (COVID-19) is diagnosed by positive result of reverse transcription polymerase chain reaction (RT-PCR) for the novel coronavirus. We concluded that cycle threshold value (Ct-value) of real-time RT-PCR (rRT-PCR) assay could decrease as patients recover. Results of rRT-PCR assay could remain positive among asymptomatic patients for longer than 2 weeks. The discharge criteria of COVID-19 patients using a negative result of rRT-PCR should be reconsidered.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Neumonía Viral/diagnóstico , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Adolescente , Adulto , Anciano de 80 o más Años , Enfermedades Asintomáticas , Betacoronavirus/aislamiento & purificación , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/virología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Nasofaringe/virología , Pandemias , Alta del Paciente , Neumonía Viral/virología , Índice de Severidad de la Enfermedad , Carga Viral , Adulto Joven
7.
J Infect Chemother ; 27(1): 76-82, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33051144

RESUMEN

INTRODUCTION: The severity of coronavirus disease (COVID-19) in Japanese patients is unreported. We retrospectively examined significant factors associated with disease severity in symptomatic COVID-19 patients (COVID-Pts) admitted to our institution between February 20 and April 30, 2020. METHODS: All patients were diagnosed based on the genetic detection of severe acute respiratory syndrome coronavirus 2. Information on the initial symptoms, laboratory data, and computed tomography (CT) images at hospitalization were collected from the patients' records. COVID-Pts were categorized as those with critical or severe illness (Pts-CSI) or those with moderate or mild illness (Pt-MMI). All statistical analyses were performed using R software. RESULTS: Data from 61 patients (16 Pt-CSI, 45 Pt-MMI), including 58 Japanese and three East Asians, were analyzed. Pt-CSI were significantly older and had hypertension or diabetes than Pt-MMI (P < 0.001, 0.014 and < 0.001, respectively). Serum albumin levels were significantly lower in Pt-CSI than in Pt-MMI (P < 0.001), whereas the neutrophil-to-lymphocyte ratio and C-reactive protein level were significantly higher in Pt-CSI than in Pt-MMI (P < 0.001 and P < 0.001, respectively). In the CT images of 60 patients, bilateral lung lesions were more frequently observed in Pt-CSI than in Pt-MMI (P = 0.013). Among the 16 Pt-CSI, 15 received antiviral therapy, 12 received tocilizumab, five underwent methylprednisolone treatment, six received mechanical ventilation, and one died. CONCLUSIONS: The illness severity of Japanese COVID-Pts was associated with older age, hypertension and/or diabetes, low serum albumin, high neutrophil-to-lymphocyte ratio, and C-reactive protein.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Índice de Severidad de la Enfermedad , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Anticuerpos Monoclonales Humanizados/uso terapéutico , Antivirales/uso terapéutico , Betacoronavirus , Proteína C-Reactiva/análisis , Infecciones por Coronavirus/terapia , Femenino , Humanos , Japón/epidemiología , Pulmón/diagnóstico por imagen , Pulmón/patología , Masculino , Metilprednisolona/uso terapéutico , Persona de Mediana Edad , Neutrófilos , Pandemias , Neumonía Viral/terapia , Respiración Artificial , Estudios Retrospectivos , Factores de Riesgo , Albúmina Sérica/análisis , Tomografía Computarizada por Rayos X , Adulto Joven
8.
Sci Total Environ ; 753: 142351, 2021 Jan 20.
Artículo en Inglés | MEDLINE | ID: mdl-33207470

RESUMEN

BACKGROUND: Lead (Pb) concentration in bone is a reliable biomarker for cumulative Pb exposure and studying associated health outcomes. However, the standard K-shell fluorescence (KXRF) bone Pb measurement technology has limitations in large-scale population studies. OBJECTIVE: We compared measurements from a portable XRF device and a KXRF device. METHODS: We measured bone Pb concentrations in vivo using portable XRF and KXRF, each measured at the mid-tibia bone in 71 people, 38-95 years of age (mean ± SD = 63 ± 11 years) living in or near three Indiana communities, US; 10 participants were occupationally exposed. We estimated the correlation between bone Pb concentrations measured by both devices. We also examined the extent to which the detection limit (DL) of the portable XRF was influenced by scan time and overlying soft tissue thickness. Finally, we quantified the associations of estimated bone Pb concentration with age and age with soft tissue thickness. RESULTS: The mean bone Pb concentration measured via portable XRF was 12.3 ± 16.7 mg Pb/kg dry bone. The uncertainty of a 3-minute (N = 60) in vivo portable XRF measurement ranged from 1.8 to 6.3 mg/kg, in the context of soft tissue thickness ranging from 2 to 6 mm. This uncertainty was reduced by a factor of 1.4 with 5-minute measurements (N = 11). Bone Pb measurements via portable XRF and KXRF were significantly correlated: r = 0.48 for all participants, and r = 0.73 among participants with soft tissue thickness < 6 mm (72% of the sample). Bone Pb concentrations were higher among participants who were older or were occupationally exposed to Pb. Soft tissue thickness decreased with age. CONCLUSION: With its ease of use, portability, and comparable sensitivity with conventional KXRF systems, the portable XRF could be a valuable tool for non-invasive quantification of bone Pb in vivo, especially for people with thinner soft tissue.


Asunto(s)
Huesos , Plomo , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Indiana , Persona de Mediana Edad , Espectrometría por Rayos X , Tibia
9.
Rev. enferm. UERJ ; 28: e49370, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1122754

RESUMEN

Objetivos: descrever a média total de independência geral e por domínios de comunicação dos idosos da comunidade e verificar as variáveis sociodemográficas e de saúde associadas à maior média de independência de comunicação entre os idosos. Métodos: estudo transversal e analítico, desenvolvido entre 808 idosos da comunidade. Procederam-se às análises: descritiva, bivariada e regressão linear múltipla (p<0,05). Resultados: verificou-se necessidade mínima de auxílio na comunicação (6,43±0,77); quanto aos domínios obteve maior escore de independência de comunicação nas necessidades básicas (6,88±0,51) e menor na leitura, escrita e conceitos numéricos (5,96±1,63). A maior média de independência de comunicação associou-se à faixa etária 60├80 (p<0,001); ter escolaridade (p<0,001); renda maior que um salário mínimo (p<0,001); à ausência do declínio cognitivo (p<0,001) e do indicativo de sintomas depressivos (p=0,014). Conclusão: a escolaridade, menor idade, maior renda e a ausência do declínio cognitivo e do indicativo de sintomas depressivos contribuíram para maior independência de comunicação.


Objectives: to describe the total mean of independence and communication domains of the elderly in the community, and to verify the sociodemographic and health variables associated with the highest mean of independence of communication among the elderly. Methods: A cross - sectional and analytical study developed among 808 elderly people in the community. The analyzis were: descriptive, bivariate and linearly multiple regression (p<0.05). Results: There was a minimum need for assistance in communication (6.43 ± 0.77); concerning the domains, it obtained a higher score of communication independence in basic needs (6.88 ± 0.51) and lower in reading, writing and numerical concepts (5.96 ± 1.63). The highest average of communication independence was associated with the age group 60├80 (p<0.001); having schooling (p<0.001); income greater than a minimum wage (p<0.001); the absence of cognitive decline (p<0.001) and indicative of depressive symptoms (p=0.014). Conclusion: Schooling, lower age, higher income and the absence of cognitive decline and indicative of depressive symptoms contributed to greater communication independence.


Objetivos: describir el promedio general de independencia y los ámbitos de comunicación de los ancianos de la comunidad y verificar las variables sociodemográficas y de salud asociadas a la mayor media de independencia de comunicación entre los ancianos. Métodos: Estudio transversal y analítico, desarrollado entre 808 ancianos de la comunidad. Se realizaron los análisis: descriptiva, bivariada y regresión linealmente dolara (p<0,05). Resultados: Se verificó la mínima ayuda de comunicación (6,43 ± 0,77); En cuanto a los dominios, una puntuación más alta de independencia de comunicación en necesidades básicas (6,88 ± 0,51) y menor en lectura, escritura y conceptos numéricos (5,96 ± 1,63). Un promedio mayor de independencia de comunicación se asoció a la franja etaria 60├80 (p<0,001); tener escolaridad (p<0,001); el ingreso mayor que un salario mínimo (p<0,001); la ausencia del cognitivo (p<0,001) y del indicativo de síntomas depresivos (p=0,014). Conclusión: La escolaridad, menor edad, menor renta y la ausencia del cognitivo y del indicador de síntomas depresivos contribuyeron a una mayor independencia de comunicación.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Salud del Anciano , Comunicación , Brasil , Actividades Cotidianas , Demografía , Estudios Transversales , Depresión , Escolaridad , Disfunción Cognitiva , Renta , Atención de Enfermería
10.
Rev. enferm. UERJ ; 28: e44773, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1119608

RESUMEN

Objetivo:descrever a frequência dos fatores de risco cardiovascular em idosos de uma comunidade quilombola. Método: estudo transversal desenvolvido com idosos quilombolas cadastrados na Estratégia Saúde da Família. A coleta foi realizada com uma amostra de 62 idosos, utilizando-se o teste do qui-quadrado para análise dos dados. Resultados: as frequências dos fatores de risco foram: 67,7% de hipertensão arterial, 54,8% de adiposidade abdominal, 22,6% de glicemia capilar elevada, 19,4% de excesso de peso, 3,2% de sedentarismo e 3,2% de tabagismo, com diferença estatística apenas para adiposidade abdominal em idosas de cor branca (p<0,05). Conclusão: o estudo identificou elevada frequência de fatores de risco cardiovasculares nos idosos quilombolas atendidos na atenção primária à saúde, com destaque para hipertensão arterial, adiposidade abdominal e glicemia capilar elevada. Os resultados apontam a necessidade de melhoria de acesso da comunidade quilombola aos serviços de saúde.


Objective: to describe the frequency of cardiovascular risk factors in the older adults of a quilombola community. Method: in this cross-sectional study of 62 older adults of a quilombo registered with Brazil's Family Health Strategy, the data collected were analyzed using the Chi-square test. Results: risk factor frequencies were: 67.7% for arterial hypertension; 54.8%, abdominal adiposity; 22.6%, high capillary blood glucose; 19.4%, overweight; 3.2%, sedentary lifestyle; and 3.2%, smoking. Statistical difference was observed only for abdominal adiposity in older, white women (p<0.05). Conclusion: this study identified a high frequency of cardiovascular risk factors in quilombola older adults treated in primary health care, particularly arterial hypertension, abdominal adiposity, and high capillary blood glucose. These results indicate the need to improve quilombola communities' access to health services.


Objetivo: describir la frecuencia de factores de riesgo cardiovascular en los adultos mayores de una comunidad quilombola. Método: en este estudio transversal de 62 adultos mayores de un quilombo inscrito en la Estrategia de Salud de la Familia de Brasil, los datos recolectados se analizaron mediante la prueba de Chi-cuadrado. Resultados: las frecuencias de los factores de riesgo fueron: 67,7% para la hipertensión arterial; 54,8%, adiposidad abdominal; 22,6%, glucemia capilar elevada; 19,4%, sobrepeso; 3,2%, sedentarismo; y 3,2%, tabaquismo. Se observó diferencia estadística solo para la adiposidad abdominal en mujeres blancas mayores (p<0,05). Conclusión: este estudio identificó una alta frecuencia de factores de riesgo cardiovascular en adultos mayores quilombolas tratados en atención primaria de salud, particularmente hipertensión arterial, adiposidad abdominal y glucemia capilar alta. Estos resultados indican la necesidad de mejorar el acceso de las comunidades quilombolas a los servicios de salud.


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares , Grupos Étnicos , Factores de Riesgo , Accesibilidad a los Servicios de Salud , Tabaquismo , Glucemia , Brasil , Epidemiología Descriptiva , Estrategia de Salud Familiar , Circunferencia Abdominal , Conducta Sedentaria , Hipertensión , Obesidad
11.
Rev. enferm. UERJ ; 28: e47321, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1116094

RESUMEN

Objetivo: analisar a produção científica nacional e internacional, buscando as interfaces existentes entre os princípios bioéticos e os cuidados em saúde prestados ao fim da vida às pessoas idosas. Método: revisão integrativa, cuja busca ocorreu entre outubro e novembro de 2019 nas bases de dados Medline via Pubmed, Lilacs e Scopus com os descritores: "Palliative Care", "Aged" e "Bioethics" de 2014-2019. Resultados: a partir dos artigos selecionados, emergiram as seguintes categorias: condutas terapêuticas frente aos cuidados ao fim da vida; tomada de decisão nos cuidados ao fim da vida; e desafios nos cuidados ao fim da vida. Conclusão: destaca-se a relevância dos profissionais manterem o compromisso com a pessoa idosa e sua família de forma a considerar suas subjetividades e preferências e os instrumentalizar para que os cuidados sejam pautados em princípios bioéticos, para assim proporcionar um processo de morte e de morrer com dignidade.


Objective: to examine the Brazilian and international scientific production for connections between bioethical principles and the health care provided to older adults at the end of their lives. Method: between October and November 2019 this integrative review searched the Medline (Pubmed), Lilacs, and Scopus databases using the descriptors: "Palliative Care", "Aged", and "Bioethics" for the period 2014-2019. Results: the following categories emerged from the selected articles: therapeutic conducted with regard to end-of-life care; decision making on end-of-life care; and challenges in end-of-life care. Conclusion: of particular importance is for health professionals to uphold their commitment to older adults and their families, consider their subjectivities and preferences, and empower and equip them so that care is guided by bioethical principles in order to assure a dignified process of dying and death.


Objetivo: examinar la producción científica brasileña e internacional en busca de conexiones entre los principios bioéticos y la atención médica brindada a los adultos mayores al final de sus vidas. Método: entre octubre y noviembre de 2019, esta revisión integradora buscó en las bases de datos Medline (Pubmed), Lilacs y Scopus utilizando los descriptores: "Cuidados paliativos", "Envejecido" y "Bioética" para el período 2014-2019. Resultados: las siguientes categorías surgieron de los artículos seleccionados: terapéutico realizado con respecto a la atención al final de la vida; toma de decisiones sobre la atención al final de la vida; y desafíos en la atención al final de la vida. Conclusión: es de particular importancia que los profesionales de la salud mantengan su compromiso con los adultos mayores y sus familias, consideren sus subjetividades y preferencias, y los empoderen y equipen para que la atención se guíe por principios bioéticos para asegurar un proceso digno de muerte y muerte.


Asunto(s)
Humanos , Anciano , Anciano de 80 o más Años , Actitud del Personal de Salud , Cuidados Paliativos al Final de la Vida/ética , Discusiones Bioéticas , Personeidad , Muerte , Relaciones Profesional-Familia/ética , Relaciones Profesional-Paciente/ética , Actitud Frente a la Muerte , Valor de la Vida
12.
Rev. enferm. UERJ ; 28: e35054, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1117622

RESUMEN

Objetivo: avaliar a mobilidade do cliente com dermatose imunobolhosa antes e após aplicação do curativo com gaze vaselinada. Método: estudo quase experimental, interinstitucional, com clientes com dermatoses imunobolhosas hospitalizados em um hospital estadual e um hospital federal do Estado do Rio de Janeiro e uma instituição do Mato Grosso do Sul. Utilizou-se a lógica fuzzy para classificar a mobilidade dos sujeitos antes, 24 horas após e uma semana após aplicação do curativo. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa. Resultados: Incluídos 14 participantes, sendo nove com pênfigo vulgar, dois com pênfigo foliáceo e três com penfigóide bolhoso, entre 27 e 82 anos, predominando 11 mulheres. Após 24 horas, nenhum participante se considerou com baixa mobilidade, sete passaram a mobilidade média, e sete, alta, o que foi mantido uma semana após aplicação do curativo. Conclusão: constatou-se significativo aumento da mobilidade logo nas primeiras 24 horas após aplicação do curativo.


Objective: to assess the mobility of clients with immunobullous dermatoses, before and after applying vaseline gauze dressings. Method: in this quasi-experimental, interinstitutional study of inpatients with immunobullous dermatoses at a state hospital and a federal hospital in Rio de Janeiro State and an institution in Mato Grosso do Sul (Brazil), patient mobility before, 24 hours after, and one week after applying the dressing was classified using fuzzy logic. The study was approved by the research ethics committee. Results: 14 participants, nine with pemphigus vulgaris, two with pemphigus foliaceus, and three with bullous pemphigoid, aged between 27 and 82 years old, and predominantly (11) women. After 24 hours, none of the participants considered their mobility to be poor, seven began to be moderately mobile, and seven were highly mobile, and continued so one week after applying the dressing. Conclusion: mobility increased significant in the first 24 hours after applying the dressing.


Objetivo: evaluar la movilidad de clientes con dermatosis inmunobullosa, antes y después de la aplicación de apósitos de gasa con vaselina. Método: en este estudio cuasi-experimental, interinstitucional de pacientes hospitalizados con dermatosis inmunobullosa en un hospital estatal y un hospital federal en el estado de Río de Janeiro y una institución en Mato Grosso do Sul (Brazil), la movilidad del paciente antes, 24 horas después y una semana después la aplicación del apósito se clasificó mediante lógica difusa. El estudio fue aprobado por el comité de ética en investigación. Resultados: se incluyeron 14 participantes, nueve con pénfigo vulgar, dos con pénfigo foliáceo y tres con penfigoide ampolloso, con edades comprendidas entre 27 y 82 años, y predominantemente mujeres (n=11). Después de 24 horas, ninguno de los participantes consideró que su movilidad fuera pobre, siete comenzaron a ser moderadamente móviles y siete eran altamente móviles, y así continuaron una semana después de la aplicación del apósito. Conclusión: la movilidad aumentó significativamente en las primeras 24 horas después de la aplicación del apósitoconsideraba con baja movilidad, siete comenzaron a tener movilidad media y siete, alta, que se mantuvo una semana después de aplicar el apósito. Conclusión: hubo un aumento significativo en la movilidad en las primeras 24 horas después de aplicar el apósito.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Vaselina/uso terapéutico , Vendajes , Enfermedades Cutáneas Vesiculoampollosas/terapia , Penfigoide Ampolloso/terapia , Pénfigo/terapia , Limitación de la Movilidad , Brasil , Lógica Difusa , Úlcera por Presión/prevención & control , Prevención Secundaria , Ensayos Clínicos Controlados no Aleatorios como Asunto , Hospitales Públicos , Pacientes Internos , Atención de Enfermería
13.
Goiânia; s.n; 06 nov. 2020. 1-23 p. ilus, tab, mapas, graf.(Boletim Epidemiológico Covid-19, 31).
Monografía en Portugués | Coleciona SUS, CONASS, SES-GO | ID: biblio-1128737

RESUMEN

O Boletim epidemiológico COVID-19, da Secretaria de Estado da Saúde do Estado de Goiás (SES-GO) objetiva apresentar as informações oficiais da situação epidemiológica referente ao período compreendido entre 04 de fevereiro à 31 de outubro de 2020. No Estado de Goiás, 255.744 (35,3%) foram confirmados sendo 244.877 (95,8%) por critério laboratorial, 7.152 (2,8%) pelo critério clínico epidemiológico, 1.054 (0,4%) por critério clínico-imagem e 2.106 (0,8%) pelo critério clínico, 226.894 (31,3%) foram descartados e 242.166 (33,4%) continuam como suspeitos. Na SE 44 foram realizados 601 testes (26,9% a menos do que na SE anterior), sendo 120 (19,9%) positivos e 480 (79,9%) negativos e 1 (0,2) inconclusivo


The epidemiological bulletin COVID-19, of the State Department of Health of the State of Goiás (SES-GO) aims to present the official information of the epidemiological situation referring to the period from February 4 to October 31, 2020. In the State of Goiás, 255,744 (35.3%) were confirmed, with 244,877 (95.8%) by laboratory criterion, 7,152 (2.8%) epidemiological clinical criterion, 1,054 (0.4%) by clinical-imaging criterion and 2,106 (0.8%) by clinical criterion, 226,894 (31.3%) were discarded and 242,166 (33.4%) remain as suspects. In the SE 44, 601 tests were performed (26.9% less than in the previous SE), 120 (19.9%) positive and 480 (79.9%) negative and 1 (0.2) inconclusive


Asunto(s)
Humanos , Masculino , Femenino , Embarazo , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Neumonía Viral/epidemiología , Infecciones por Coronavirus/epidemiología , Pandemias , Betacoronavirus , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Brasil/epidemiología , Incidencia , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Monitoreo Epidemiológico
14.
Goiânia; s.n; Nov. 13, 2020. 1-22 p. ilus, mapas, graf, tab.(Boletim Epidemiológico Covid-19, 32).
Monografía en Portugués | Coleciona SUS, CONASS, SES-GO | ID: biblio-1128966

RESUMEN

O Boletim epidemiológico COVID-19, da Secretaria de Estado da Saúde do Estado de Goiás (SES-GO) objetiva apresentar as informações oficiais da situação epidemiológica do Estado de Goiás referente ao período compreendido entre 04 de fevereiro a 07 de novembro de 2020. Nesta última semana epidemiológica (SE 45) houve a confirmação de 5.895 casos novos, representando uma redução de 29%, inferior a redução observada no Brasil, 75%. No Estado, 261.639 (35,3%) foram confirmados sendo 250.066 (95,6%) por critério laboratorial, 7.544 (2,9%) pelo critério clínico epidemiológico, 1.157 (0,4%) por critério clínico-imagem e 2.262 (0,9%) pelo critério clínico, 235.601 (31,8%) foram descartados e 243.031 (32,8%) continuam como suspeitos. Na SE 45 foram realizados 460 testes (23,4% a menos do que na SE anterior), sendo 80 (17,3%) positivos, 379 (82,3%) negativos e 2 (0,4) inconclusivos


The epidemiological bulletin COVID-19, of the State Department of Health of the State of Goiás (SES-GO) aims to present the official information of the epidemiological situation of the State of Goiás for the period from February 4 to November 7, 2020. In this last epidemiological week (SE 45) there was confirmation of 5,895 new cases, representing a reduction of 29%, lower than the reduction observed in Brazil, 75%. In the State, 261,639 (35.3%) were confirmed being 250,066 (95.6%) by laboratory criterion, 7,544 (2.9%) by epidemiological clinical criterion, 1,157 (0.4%) by clinical-imaging criterion and 2,262 (0.9%) by clinical criterion, 235,601 (31.8%) were discarded and 243,031 (32.8%) remain as suspects. In the SE 45, 460 tests were performed (23.4% less than in the previous SE), 80 (17.3%) positive, 379 (82.3%) negative and 2 (0.4) inconclusive


Asunto(s)
Humanos , Embarazo , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Neumonía Viral/epidemiología , Infecciones por Coronavirus/epidemiología , Pandemias , Betacoronavirus , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Brasil/epidemiología , Incidencia , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Monitoreo Epidemiológico
17.
Goiânia; s.n; nov. 20, 2020. 1-22 p. ilus, mapas, graf, tab.(Boletim Epidemiológico Covid-19, 33).
Monografía en Portugués | Coleciona SUS, CONASS, SES-GO | ID: biblio-1129714

RESUMEN

O Boletim epidemiológico COVID-19, da Secretaria de Estado da Saúde de Goiás (SES-GO), Brasil, objetiva apresentar as informações oficiais da situação epidemiológica do Estado no período compreendido entre o registro dos primeiros casos suspeitos em Goiás, a partir de 04 de fevereiro e até 14 de novembro do ano de 2020, foram notificados à Vigilância Epidemiológica 757.860 casos de COVID-19. Nesta última semana epidemiológica (SE 46) houve a confirmação de 6.196 casos novos, representando um aumento de 5%, inferior a redução observada no Brasil, 699%. No Estado, 267.835 (35,3%) foram confirmados sendo 255.483 (95,4%) por critério laboratorial, 7.544 (2,8%) pelo critério clínico-epidemiológico, 1.237 (0,5%) por critério clínico-imagem e 2.626 (1,0%) pelo critério clínico, 247.542 (32,7%) foram descartados e 242.483 (32,0%) continuam como suspeitos. Na SE 46 foram realizados 724 testes (57,4% a mais do que na SE anterior), sendo 92 (12,7%) positivos, 632 (87,3%) negativos


The epidemiological bulletin COVID-19, of the State Department of Health of Goiás (SES-GO), Brazil, aims to present the official information of the epidemiological situation of the State in the period between the registration of the first suspected cases in Goiás, from February 4 and until November 14 of the year 2020, were notified to the Epidemiological Surveillance 757,860 cases of COVID-19. In this last epidemiological week (SE 46) there was the confirmation of 6,196 new cases, representing an increase of 5%, lower than the reduction observed in Brazil, 699%. In the State, 267,835 (35.3%) were confirmed to be 255,483 (95.4%) by laboratory criterion, 7,544 (2.8%) by clinical and epidemiological criterion, 1,237 (0.5%) by clinical-imaging criterion and 2,626 (1.0%) by clinical criterion, 247,542 (32.7%) were discarded and 242,483 (32.0%) remain as suspects. In the SE 46, 724 tests were performed (57.4% more than in the previous SE), 92 (12.7%) positive, 632 (87.3%) negative


Asunto(s)
Humanos , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Neumonía Viral/epidemiología , Infecciones por Coronavirus/embriología , Pandemias , Betacoronavirus , Brasil/epidemiología , Incidencia , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Monitoreo Epidemiológico
18.
Wiad Lek ; 73(9 cz. 2): 1904-1908, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33148832

RESUMEN

OBJECTIVE: Introduction: Lifestyle modification, including changing eating habits, plays an essential role in the prevention of stroke. The aim: The study aimed to assess the nutritional prevention of cerebrovascular diseases in adult inhabitants of Poland. PATIENTS AND METHODS: Material and Methods: The study was conducted using the author's questionnaire among 145 women and 76 men, aged 18 - 30 (53.9%) and 50 - 70 (46.1%) years. RESULTS: Results: The following stroke risk factors were found in the examined group: overweight or obesity (46.6%), lack of regular physical activity (48%), smoking (33%), hypertension (22.1%), dyslipidemia (8.6%), diabetes (5.9%), and cardiac arrhythmias (6.3%). The younger subjects compared to older ones more often declared the daily consumption of whole-grain cereal products and vegetables, fish at least once a week, and they preferred vegetable oils. On the other hand, older subjects declared the consumption of sweets, sweet drinks, salt, and fast food less frequently than younger ones. Also, fruits were more often chosen by older people. Both groups declared similar moderate consumption of milk and dairy products with reduced fat content, lean meat, and alcohol. Only 38% of respondents considered their eating habits to be appropriate. CONCLUSION: Conclusions: The eating habits of examined adults only partially met the recommendations regarding the nutritional prevention of stroke. In some elements, younger people were more likely to follow appropriate dietary recommendations, while older people were more appropriate in others. The education regarding the principles of the nutritional prevention of cerebrovascular diseases is still necessary and should be age-appropriate.


Asunto(s)
Conducta Alimentaria , Accidente Cerebrovascular , Adulto , Anciano , Anciano de 80 o más Años , Dieta , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polonia , Accidente Cerebrovascular/prevención & control , Encuestas y Cuestionarios , Verduras
19.
Wiad Lek ; 73(9 cz. 2): 1957-1961, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33148840

RESUMEN

OBJECTIVE: The aim: Is to determine the main causes of adverse outcomes of the patients' treatment with acute ulcerative gastroduodenal bleeding and to develop preventive measures to improve the quality of the patients' treatment with this pathology. PATIENTS AND METHODS: Materials and methods: A retrospective analysis of the treatment results of 1323 patients with bleeding of ulcerative etiology has been carried out. There are 375 patients with gastric ulcer (28.3%) and 948 patients (71.7%) with duodenal ulcer among them. The patients' age ranged from 15 to 93 years old. Concomitant pathology was observed in 623 (47.1%) patients, the most common of which were coronary heart disease, chronic non-specific lung diseases and cerebrovascular diseases. Mild severity of blood loss was detected in 404 (30.5%) patients, moderate severity 693 (52.5%), severe 145 (10.9%) and extremely severe 81 (6.1%). Overall mortality was 5.9%, postoperative mortality 6.3%, the mortality in conservative treatment only 6.1%. RESULTS: Results: The main cause of the patients' mortality with acute ulcerative gastroduodenal bleeding was decompensated hemorrhagic shock which developed at the prehospital stage in 45.3% and as a result of bleeding recurrence during treatment 44.2% of the patients. Inadequate drug therapy increases the risk of bleeding recurrence from 15.8 to 32.7%. The use of proton pump blockers and the combination of bolus and prolonged use of proton pump blockers allow to reduce the risk of bleeding recurrence by half (up to 6.8%). CONCLUSION: Conclusions: Endoscopic hemostasis in combination with the injection method with diathermocoagulation or thermal coagulation can be considered as full-fledged, and when performing endoscopic monitoring the preference should be given to coagulation methods of diathermo- and hydrodietermocoagulation.


Asunto(s)
Úlcera Duodenal , Hemostasis Endoscópica , Úlcera Gástrica , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Humanos , Persona de Mediana Edad , Úlcera Péptica Hemorrágica/terapia , Recurrencia , Estudios Retrospectivos , Úlcera Gástrica/complicaciones , Adulto Joven
20.
Swiss Dent J ; 130(11): 876-884, 2020 11 09.
Artículo en Inglés | MEDLINE | ID: mdl-33140630

RESUMEN

The objective of this study was to explore the preferred dental services of older people for when they become dependent. It aimed to assess their preferred type of health care professional and location of dental service, and relate their preferences to their willingness to pay (WTP) and willingness to travel (WTT). Older people aged 65 years or older were invited to participate in a questionnaire-based discrete choice experiment (DCE), to measure preferences for dental examinations and treatment, defined by two attributes: type of professional and location of the activity. Hypothetical scenarios based attributes were displayed in a projected visual presentation and participants noted their personal preference using a response sheet. Data was analyzed using a random-effects logit model. Eighty-nine participants (mean age 73.7 ± 6.6 years) attended focus group sessions. Respondents preferred that the family dentist (ß: 0.2596) or an auxiliary (ß: 0.2098) undertake the examination and wanted to avoid a medical doctor (ß: ­0.469). The preferred location for dental examination was at a dental practice (ß: 0.2204). Respondents preferred to avoid treatments at home (ß: ­0.3875); they had a significant preference for treatment at the dental office (ß: 0.2255) or in a specialist setting (ß: 0.1620, ns). However, the type of professional did not have a significant influence on overall preference. Participants with a low WTP preferred examination at home (ß: 0.2151) and wanted to avoid the dental practice (ß: ­0.0235), whereas those with a high WTP preferred the dental office (ß: 0.4535) rather than home (ß: ­0.3029). WTT did not have a significant influence on preference. The study showed that older people generally preferred receiving dental services in a dental practice or specialist setting, and would prefer not to be treated at home. Continuity of dental services provided by the family dentist should therefore be prioritized where possible and further studies should examine the role of domiciliary care at home.


Asunto(s)
Cuidado Dental para Ancianos , Prioridad del Paciente , Anciano , Anciano de 80 o más Años , Humanos , Encuestas y Cuestionarios , Suiza
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