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1.
Texto & contexto enferm ; 29: e20180250, Jan.-Dec. 2020. tab, graf
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1059129

RESUMEN

ABSTRACT Objective: to analyze the health promotion practices developed by nurses in the care of people with non-transmittable chronic disease in primary health care, in scientific publications, between 2007 and 2017. Method: an integrative literature review of a qualitative approach, conducted in five databases, in which was read and critical analysis of the studies in order to know the practices of health promotion. Results: 40 articles were selected and organized according to the fields of the Ottawa Charter: public policies, reorientation of health services, creation of personal skills, reinforcement of community action and favorable environments. Thus, most of the experiments were mainly related to two fields of action: development of personal skills and reorientation of the health system. There is a movement towards the development of a health promotion in which the collective, the social determinants of health and multidisciplinarity are advocated. Conclusion: some limits were identified that need to be overcome, among which stands out the inter-sectoral work that needs to grow beyond the health sector.


RESUMEN Objetivo: analizar las prácticas de promoción de la salud llevadas a cabo por los enfermeros al cuidar d personas con enfermedades crónicas no transmisible en la atención primaria de la salud, en publicaciones científicas de 2007 a 2017. Método: revisión integradora de la literatura con enfoque cualitativo realizada en cinco bases de datos, en las que se efectuó una lectura y un análisis crítico de los estudios de modo de conocer las prácticas de promoción de la salud. Resultados: se seleccionaron 40 artículos y se los organizó de acuerdo con los campos de la Carta de Ottawa: políticas públicas, reorientación de los servicios de salud, desarrollo de habilidades personales, refuerzo de la acción comunitaria y ambientes favorables. De esta manera, la mayor parte de las experiencias se relacionó principalmente con dos campos de acción: desarrollo de habilidades personales y reorientación del sistema de salud. Se nota un desplazamiento en dirección al desarrollo de un enfoque de promoción de salud en el que se promueve lo colectivo, los determinantes sociales de la salud y de la multidisciplinariedad. Conclusión: se identificaron algunos límites que deben superarse, dentro de los cuales se destaca el trabajo intersectorial que debe extenderse más allá dl sector de la salud.


RESUMO Objetivo: analisar as práticas de promoção da saúde desenvolvidas pelos enfermeiros no cuidado às pessoas com doença crônica não transmissível na atenção primária à saúde, em publicações científicas entre de 2007 e 2017. Método: revisão integrativa de literatura de abordagem qualitativa, realizada em cinco bases de dados, nos quais se fez uma leitura e análise crítica dos estudos de modo a conhecer as práticas de promoção da saúde. Resultados: foram selecionados 40 artigos, sendo organizados de acordo com os campos da Carta de Ottawa: políticas públicas, reorientação dos serviços de saúde, criação de habilidades pessoais, reforço da ação comunitária e ambientes favoráveis. Dessa forma, a maior parte das experiências estava relacionada principalmente a dois campos de ação: desenvolvimento de habilidades pessoais e reorientação do sistema de saúde. Observou-se um movimento em direção ao desenvolvimento de uma promoção da saúde em que se preconiza o coletivo, os determinantes sociais da saúde e a multidisciplinaridade. Conclusão: identificaram-se alguns limites que precisam ser transpostos, dentre os quais se destaca o trabalho intersetorial que precisa crescer para além do setor saúde.


Asunto(s)
Atención Primaria de Salud , Enfermedad Crónica , Enfermería , Política Pública , Participación de la Comunidad , Promoción de la Salud , Literatura , Atención de Enfermería
2.
Texto & contexto enferm ; 29: e20180399, Jan.-Dec. 2020. tab, graf
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1101980

RESUMEN

ABSTRACT Objective: to evaluate the effectiveness of educational interventions in improving the quality of life of people with arterial hypertension. Method: an integrative literature review which included studies that conducted educational interventions aimed at the hypertensive public to improve quality of life. The search was performed in the following databases: MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO and CINAHL, without restriction of language, date and sample size. For this, the following descriptors were crossed: "hipertensão" (hypertension), "educação em saúde" (health education) and "qualidade de vida" (quality of life). 619 articles were retrieved and after the selection and analysis process, a total of 10 made up this review. Data extraction and analysis were performed with the help of validated instruments and the result summarized. Results: Most studies were developed on a quasi-experimental basis, using generic instruments to measure quality of life with significant improvement after educational interventions, with group technology being the most used educational strategy. Just one study used a specific instrument to evaluate hypertensive patients. Conclusion: these results may direct the interventions to be implemented by health professionals in managing arterial hypertension. Further investigations are needed to identify and verify the most effective interventions for hypertensive patients, considering heterogeneous profiles and aiming at improving quality of life.


RESUMO Objetivo: evaluar la eficacia de las intervenciones educativas en el mejoramiento de la calidad de vida de personas con hipertensión arterial. Método: revisión integradora de la literatura que incluyó estudios que han realizado intervenciones educativas direccionadas al público hipertenso con el objetivo de mejorar su calidad de vida. La búsqueda se realizó en las bases de datos MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO e CINAHL, sin restricción de idioma, fecha ni tamaño de muestra. A tal efecto, se utilizaron los descriptores "hipertensión", "educación en salud" y "calidad de vida". Se tomaron 619 artículos y luego de un proceso de selección y análisis esta revisión se compone de un total de 10. La extracción y el análisis de datos se realizaron con el auxilio de instrumentos validados e se procedió a la síntesis de los resultados. Resultados: la mayor parte de los estudios se desarrolló con carácter casi experimental mediante el uso instrumentos genéricos para medir la calidad de vida, con significativa mejoría después de realizadas las intervenciones educativas, siendo la tecnología grupal la estrategia educacional más utilizada. Apenas un estudio utilizó un instrumento específico para la evaluación de hipertensos. Conclusión: estos resultados pueden direccionar las intervenciones que deben llevarse a cabo por profesionales de la salud en el manejo de la presión arterial. Es necesario profundizar las investigaciones para identificar y verificar las intervenciones más eficientes en pacientes hipertensos, considerando perfiles heterogéneos a fin de mejorar su calidad de vida.


RESUMO Objetivo: avaliar a efetividade de intervenções educativas na melhora da qualidade de vida de pessoas com hipertensão arterial. Método: revisão integrativa da literatura que incluiu estudos que realizaram intervenções educacionais direcionadas ao público hipertenso com vistas à melhora da qualidade de vida. Busca realizada nas bases de dados: MEDLINE, LILACS, IBECS, CUMED, BDENF, SciELO e CINAHL, sem restrição de idioma, data e tamanho amostral. Para tal, cruzaram-se os descritores: "hipertensão", "educação em saúde" e "qualidade de vida". Foram resgatados 619 artigos e após o processo de seleção e análise, um total de 10 compuseram esta revisão. A extração e análise dos dados foram realizadas com auxílio de instrumentos validados e o resultado sumarizado. Resultados: a maioria dos estudos foi desenvolvida em caráter quase experimental, utilizando-se de instrumentos genéricos para mensuração da qualidade de vida com melhora significativa após a realização de intervenções educativas, sendo a tecnologia grupal a estratégia educacional mais utilizada. Apenas um estudo utilizou instrumento específico para avaliação em hipertensos. Conclusão: estes resultados podem direcionar as intervenções a serem implementadas por profissionais de saúde no manejo da hipertensão arterial. Futuras investigações são necessárias para identificar e verificar as intervenções mais eficazes aos pacientes hipertensos, considerando perfis heterogêneos e visando à melhora da qualidade de vida.


Asunto(s)
Calidad de Vida , Enfermedad Crónica , Hipertensión , Salud , Educación en Salud , Revisión , Presión Arterial , Análisis de Datos
3.
Texto & contexto enferm ; 29: e20180420, Jan.-Dec. 2020.
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1059148

RESUMEN

ABSTRACT Objectives: to describe the health control habits that influence the daily life of celiac patients and to analyze the practice of actions related to health control and its determinants, from the perspective of the first component of the Pender Health Promotion Model. Method: a cross-sectional study conducted through interviews with instrument with 83 individuals from Ceará and diagnosed with celiac disease. Data was analyzed using the characteristics and individual experiences component of Pender's theoretical model. Results: of the celiac patients, 96.4% did not follow the gluten-free diet; 80.7% had inappropriate behaviors to reduce risk factors; 72.3% made ineffective choices in daily life to achieve health goals and; and 25.3% could not keep the gluten free diet in their daily life. Conclusion: according to the theoretical model, celiac patients did not adhere to the proper diet and presented factors inherent to daily life and social issues, characterized as barriers to an effective health control.


RESUMEN Objetivos: describir los hábitos de control de la salud que influyen sobre la vida diaria de los celíacos y analizar la práctica de acciones relacionados con el control de la salud y sus factores determinantes, bajo la óptica del primer componente del Modelo de Promoción de la Salud de Pender. Método: estudio transversal realizado a través de entrevistas con instrumento con 83 individuos del estado de Ceará diagnosticados con la enfermedad celíaca. Los datos se analizaron mediante el componente de características y experiencias individuales del modelo teórico de Pender. Resultados: de los celíacos, el 96,4% no seguía la dienta sin gluten; el 80,7% presentaba comportamiento inadecuados para reducir factores de riesgo; el 72,3% realizaba elecciones ineficaces en la vida diaria para alcanzar las metas de salud y el 25,3% no lograba mantener la dieta sin gluten en su vida diaria. Conclusión: de acuerdo con el modelo teórico, los celíacos no respetaban la dieta adecuada y presentaron factores inherentes a la vida diaria y a las cuestiones sociales, caracterizados como obstáculos para un control eficaz de la salud.


RESUMO Objetivos: descrever os hábitos de controle de saúde que influenciam no cotidiano dos celíacos e analisar a prática de ações relacionadas ao controle da saúde e seus determinantes, sob o prisma do primeiro componente do Modelo de Promoção da Saúde de Pender. Método: estudo transversal, realizado com 83 indivíduos com diagnóstico de doença celíaca, do Estado do Ceará, através de entrevistas com instrumento. Os dados foram analisados mediante o componente características e experiências individuais do modelo teórico de Pender. Resultados: dos celíacos, 96,4% não seguiam a dieta isenta de glúten; 80,7% possuíam comportamentos inadequados para reduzir fatores de risco; 72,3% faziam escolhas na vida diária ineficazes para atingir as metas de saúde; e 25,3% não conseguiam manter a dieta isenta de glúten na sua vida diária. Conclusão: de acordo com o modelo teórico, os celíacos não aderiam à dieta adequada e apresentaram fatores inerentes ao cotidiano e às questões sociais, caracterizados como barreiras para o controle eficaz da saúde.


Asunto(s)
Humanos , Adulto , Enfermedad Celíaca , Enfermedad Crónica , Cooperación del Paciente , Dieta Sin Gluten , Promoción de la Salud
4.
Texto & contexto enferm ; 29: e20190075, Jan.-Dec. 2020. tab
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1101973

RESUMEN

ABSTRACT Objective: to analyze the dialogical educative process as a strategy to prepare the relatives of children with special health needs in the transition from hospital to home. Method: qualitative study developed from the Creative Sensitive Method, carried out between February and June 2018 at the Inpatient Unit of a public hospital located in the city of Rio de Janeiro. Family caregivers of nine children with special health needs in transition from hospital to home were included in the study, totaling nine participants. The empirical material was evaluated through the analysis of the French discourse. Results: the educative process allowed the relatives to unveil demands for technological and medicative care, modified habitual elements, clinically complex care and social demands to be worked on by the nurse in the transition from hospital to home. From the analysis, the following category emerged: The educative process as a strategy to prepare the relatives of children with special health needs in the transition from hospital to home. The dialogue was produced, however, without exhausting the I-You relationship, maintaining the dialogicity in the group and encouraging the exchange between the different realities of the relatives. Conclusion: the educative dialogic process is an adequate strategy to prepare the relatives of children with special health needs in the hospital-home transition, where the nurses act as coordinators, suggesting a minimum program-related content.


RESUMEN Objetivo: analizar el proceso educativo dialógico como estrategia de preparación de los familiares de niños con necesidades especiales en la transición del hospital a la casa. Método: estudio cualitativo desarrollado a partir del Método Creativo Sensible, realizado entre febrero y junio de 2018 en la Unidad de Pacientes Internados de un hospital público situado en la ciudad de Rio de Janeiro. El estudio se realizó con familiares cuidadores de nueve niños con necesidades especiales en transición del hospital hacia la casa, compuesto por el total de 9 participantes. El material empírico se evaluó por medio del análisis de discurso francés. Resultados: el proceso educativo permitió que los familiares develaran demandas de cuidados, tecnológicas y medicamentosas, cuidados habituales modificados, cuidados clínicamente complejos y demandas sociales que deben ser trabajadas por el enfermero en la transición del hospital hacia la casa. Del análisis, emergió la categoría: el proceso educativo como estrategia de preparación de los familiares de niños con necesidades especiales en la transición del hospital a la casa. El diálogo se produjo, sin embargo, sin agotar la relación yo-tu, manteniendo el carácter dialógico en el grupo e incentivando el intercambio entre las diferentes realidades de los familiares. Conclusión: el proceso educativo dialógico es una estrategia adecuada para preparar los familiares de niños con necesidades especiales de salud en la transición hospital-casa, en el cual los enfermeros actúan como coordinadores, sugiriendo un contenido programático mínimo.


RESUMO Objetivo: analisar o processo educativo dialógico como estratégia de preparo dos familiares de crianças com necessidades especiais de saúde na transição do hospital para casa. Método: estudo qualitativo desenvolvido a partir do Método Criativo Sensível, realizado entre fevereiro e junho de 2018 na Unidade de Pacientes Internos de um hospital público localizado na cidade do Rio de Janeiro. Familiares cuidadores de nove crianças com necessidades especiais de saúde em transição do hospital para casa integraram o estudo, totalizando nove participantes. O material empírico foi avaliado por meio da análise do discurso francesa. Resultados: o processo educativo permitiu que os familiares desvelassem demandas de cuidados tecnológicas e medicamentosas, habituais modificados, cuidados clinicamente complexos e demandas sociais a serem trabalhados pelo enfermeiro na transição do hospital para a casa. Da análise, emergiu a categoria: o processo educativo como estratégia de preparo dos familiares de crianças com necessidades especiais de saúde na transição do hospital para casa. O diálogo foi produzido, porém, sem esgotar a relação eu-tu, mantendo a dialogicidade no grupo e incentivando o intercâmbio entre as diferentes realidades dos familiares. Conclusão: o processo educativo dialógico é uma estratégia adequada para preparar os familiares de crianças com necessidades especiais de saúde na transição hospital-casa, no qual os enfermeiros atuam como coordenadores, sugerindo um conteúdo programático mínimo.


Asunto(s)
Adulto , Persona de Mediana Edad , Enfermería Pediátrica , Enfermedad Crónica , Niños con Discapacidad , Familia , Salud Pública , Educación en Salud , Cuidadores
5.
Rhinology ; 58(5): 522-523, 2020 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-33130830

RESUMEN

Social distancing with the aim of avoiding infections and pre-serve critical care capacities during the COVID-19 pandemic has been implemented in Germany according to World Health Organization (WHO) recommendations from early March onwards. Limitations of physical contacts to reduce exposure to SARS-CoV-2 infected individuals were handled strictly, particularly in medical centers dealing with airway diseases, like rhinology and pneumology clinics. Such measures and reluctance to visit out- and inpatient services resulted in a 82% decrease in consultations to the 12 German oto-rhino-laryngological (ORL) centres forming our database during the 50 days following March 09 in 2020 if compared to the same period in 2019. Our data on CRS care underline reports on undertreatment of non-COVID-19 individuals with several different diseases during the current pandemic. We should try to reduce the toll these patients have to pay as much as possible. We established telemedicine, e-Health and artificial intelligence-supported triage for selecting the right patients for onsite-consultations and to advise patients in several demands.


Asunto(s)
Inteligencia Artificial , Infecciones por Coronavirus , Pandemias , Neumonía Viral , Rinitis/diagnóstico , Rinitis/terapia , Sinusitis/diagnóstico , Sinusitis/terapia , Betacoronavirus , Enfermedad Crónica , Alemania/epidemiología , Humanos , Otolaringología/tendencias , Telemedicina
6.
Kardiologiia ; 60(8): 84-89, 2020 Sep 17.
Artículo en Ruso | MEDLINE | ID: mdl-33155963

RESUMEN

Aim To compare Russian versions of the scales for assessment of self-care ability in patients with chronic heart failure (CHF), European Heart Failure Self-Care Behavior Scale (EHFScBS_9) and The Self-Сare of Heart Failure Index (SCHFI, version 6.2).Materials and methods Assessment of the self-care ability was performed with Russian versions of EHFScBS_9 and SCHFI (version 6.2) scales in 130 patients with NYHA functional class II-IV CHF primarily of ischemic origin (78.5 %). Mean age of patients was 63.2±9.6 years; most of the patients were men (n=92; 70.8 %). Patients were managed in accordance with effective guidelines ESC / HFA 2016 and Russian guidelines 2018.Results Along with an increase in SСHFI scores, a decrease in EHFScBS_9 scores was observed (r= -0.31, p<0.001). The patients participating in the study showed a low self-care ability at baseline according to results of both scales.Conclusion The presence of certain differences between the study scales does not exclude a possibility of using them alone or together for more detailed assessment of the self-care ability.


Asunto(s)
Insuficiencia Cardíaca , Autocuidado , Anciano , Enfermedad Crónica , Insuficiencia Cardíaca/diagnóstico , Insuficiencia Cardíaca/terapia , Humanos , Masculino , Persona de Mediana Edad , Federación de Rusia , Encuestas y Cuestionarios
7.
Kardiologiia ; 60(8): 106-114, 2020 Sep 17.
Artículo en Ruso | MEDLINE | ID: mdl-33155966

RESUMEN

Chronic heart failure (CHF) is a wide-spread disease (from 7 to 10% in the Russian Federation) and tends to grow. Frequent, repeated hospitalizations of CHF patients are due to insufficient compliance of patients with the treatment and the absence of continuity in management of patients between the hospital and out-patient clinic. Developing a structure of specialized care could provide improvement of treatment quality, a decrease in the number of hospitalizations, and better prognosis. International experience shows that creation of specialized clinics for heart failure improves quality of medical care in CHF and decreases the frequency of re-hospitalizations and mortality. In the Russian Federation, such clinics were created in Nizhniy Novgorod, Ufa, Saint Petersburg, and several other cities. The article presents an expert consensus on the structure, functions, and equipment of departments and offices for patients with heart failure.


Asunto(s)
Insuficiencia Cardíaca , Enfermedad Crónica , Ciudades , Insuficiencia Cardíaca/terapia , Hospitalización , Humanos , Federación de Rusia
8.
Kardiologiia ; 60(8): 115-123, 2020 Sep 17.
Artículo en Ruso | MEDLINE | ID: mdl-33155967

RESUMEN

Chronic thromboembolic pulmonary hypertension (CTEPH) is a precapillary type of pulmonary hypertension with chronic obstruction of large and medium branches of pulmonary arteries along with secondary alterations in pulmonary microcirculation, which cause progressive increases in pulmonary vascular resistance and pulmonary arterial pressure and ensuing severe right heart dysfunction and heart failure. Pulmonary thromboendarterectomy (PTE) is the treatment of choice for CTEPH; however, this procedure is available not for all patients. Although the surgery performed in the conditions of centers with advanced experience generally shows good results, up to 40% of patients are technically inoperable or PTE is associated with a high risk of complications. At present, riociguat, the only officially approved drug from the class of soluble guanylate cyclase stimulators, is considered as a first-line treatment for inoperable and residual forms of STEPH. Introduction of riociguat to clinical practice can be called a real breakthrough in the treatment of patients with STEPH who cannot undergo PTE or those with relapse or persistent STEPH after the surgery.


Asunto(s)
Hipertensión Pulmonar , Embolia Pulmonar , Enfermedad Crónica , Humanos , Hipertensión Pulmonar/tratamiento farmacológico , Hipertensión Pulmonar/etiología , Embolia Pulmonar/complicaciones , Embolia Pulmonar/tratamiento farmacológico , Pirazoles , Pirimidinas , Guanilil Ciclasa Soluble
9.
Artículo en Ruso | MEDLINE | ID: mdl-33161660

RESUMEN

The study substantiates possibility of using data retrieved from electronic medical records (EMR) for analyzing comorbidity under diseases of the eye and its adnexa. The purpose of the study is to analyze prevalence and evaluate risk of development of comorbidity in patients with ophthalmologic pathology, based on the data presented in EMR. The total number of patients included into comprised 12 120 individuals. The 653 diagnoses were established and 122 703 requests for medical care were registered. The calculation was applied concerning prevalence, comorbidity index, relative risk of comorbidity. The study established prevalence and level of relative risk of development of opportunistic diseases characteristic for senile cataract and glaucoma. The obtained data on comorbidity may testify in-depth mechanisms of interaction of diseases at cellular, protein or genetic levels. The understanding of mechanisms of interaction of main and concomitant diseases can result in development of new methods of diagnostic, treatment and prevention of diseases. Thus, establishment of glaucoma diagnosis can induce physician to look for possible presence or high probability of development of prostate neoplasm that implies periodic control of prostate-specific antigen. The presented results demonstrate how EMR data can be used to identify, estimate prevalence and risk of comorbidity and also reveals pathogenic mechanisms of interaction between primary and recurrent diseases that can be applied in clinical practice.


Asunto(s)
Catarata , Registros Electrónicos de Salud , Enfermedad Crónica , Comorbilidad , Humanos , Masculino , Prevalencia
10.
Artículo en Ruso | MEDLINE | ID: mdl-33161673

RESUMEN

The achievements of modern medicine resulted in an increase of number of patients living with chronic diseases that turned out as significant burden for national economics. The oncologic diseases are one of the most widespread ones, determining patient vital prognosis. The modern achievements in medicine determine possibility of optimizing clinical prognosis and chronic course of disease. In modern Russia, the health care system functions in accordance with model of urgent, fragmented medical care that does not meet current needs of patients with chronic diseases. In Russia, actual procedures of medical care of oncologic patients do not consider interdisciplinary continuum scenario. Therefore, the need for its conceptualization. The article proposes model of continuum of oncologic care of patients in the context of an integrated health care system, that presupposes complex interdisciplinary follow-up of patients with chronic disease in situations of disease.


Asunto(s)
Prestación de Atención de Salud , Cuidados Paliativos , Enfermedad Crónica , Humanos , Federación de Rusia/epidemiología
11.
Orv Hetil ; 161(44): 1872-1876, 2020 11 01.
Artículo en Húngaro | MEDLINE | ID: mdl-33130603

RESUMEN

Összefoglaló. A táplálkozás iránti figyelmet igénylo krónikus betegségek (így a coeliakia, az 1-es típusú diabetes és a gyulladásos bélbetegségek), valamint az evészavartünetek kapcsolata egyelore kevéssé szélesköruen tanulmányozott terület serdülok körében. Az eddigi kutatási eredmények kiemelik a testkép- és evészavartünetek iránti magasabb kockázatot ezekben a betegségekben. Rizikótényezo lehet az evési szokások megváltozása, a táplálkozásra irányuló fokozott figyelem és az ételekkel, valamint az elfogyasztásuk következményeivel kapcsolatos aggodalom. A korai felismerést nehezíti, hogy az evészavartünetek sokáig rejtve maradhatnak, és átfedést mutathatnak a krónikus betegség egyes tüneteivel (például testsúlyváltozás, hasmenés, hányás, hasfájás). A fennálló evészavar-érintettség gyengítheti a krónikus betegség hatékony terápiáját, súlyosbíthatja a szövodményeket, és növelheti a mortalitási rizikót. A tünetek korai felismerése és az adekvát terápia csak multidiszciplináris szemléletben és teammunkával, a szomatikus gondozás és a pszichoterápia összehangolásával lehet eredményes. Orv Hetil. 2020; 161(44): 1872-1876. Summary. Disordered eating is not a well-understood phenomenon in diet-related chronic illnesses (e.g., celiac disease, type 1 diabetes, inflammatory bowel diseases) among adolescents. Previous research found a higher risk for eating disorders and negative body image among these patients. Following the prescribed or suggested dietary regime may lead to increased food awareness and become an eating disorder risk factor. Further risks may be the altered eating patterns, the fear from unknown food sources and its consequences. In many cases, eating disorder characteristics may be hidden and the symptoms of chronic illness (e.g., changes in weight, diarrhoea, vomiting, abdominal pain) and disordered eating can mimic each other. Disordered eating can worsen the effective therapy of physical illnesses and increase complications and mortality. Early diagnosis and adequate treatment can only be provided through multidisciplinary approach and teamwork. Orv Hetil. 2020; 161(44): 1872-1876.


Asunto(s)
Enfermedad Crónica/epidemiología , Trastornos de Alimentación y de la Ingestión de Alimentos/epidemiología , Adolescente , Humanos
12.
Vestn Otorinolaringol ; 85(5): 44-50, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-33140933

RESUMEN

TO STUDY: The effect of the elemental composition of bone tissue on the destruction of the structures of the temporal bone in chronic suppurative otitis media. PATIENTS AND METHODS: The study included 331 patients aged 16-75 years with a verified diagnosis of chronic purulent otitis media, subject to surgical treatment. Depending on the diagnosis and method of surgical treatment, patients are divided into groups: patients with tubotympanic otitis media and epitympanic-antral otitis media after reconstructive sanitation otosurgery in comparison with the control group. The elemental composition of the bone tissue of the cavities of the middle ear obtained intraoperatively was evaluated by x-ray fluorescence spectroscopy. Elements in the bone tissue of the cavities of the middle ear obtained intraoperatively were evaluated by spectrophotometric method. The data are processed by descriptive statistics methods and are presented in the form of a median and a range between quartiles with an estimate of the reliability of the intergroup differences by the Mann-Whitney U-criterion. RESULTS: A comparison of the indicators characterizing the elemental composition of the temporal bone tissue in patients with forms of chronic otitis media demonstrates the progression of the severity of pathological bone remodeling according to various options. In the dynamics of observation in patients with morphological signs of purulent destruction of the structures of the temporal bone, not only the most profound imbalance in the levels of calcium and phosphorus was revealed, but also the limitation of the levels of silicon and sulfur in a progressive and recurrent course at different periods of the disease. CONCLUSION: X-ray fluorescence spectroscopy allows an elemental chemical analysis of bone remodeling according to the pathological type and reliably differentiate purulent diseases of the temporal bone. The results are promising from the point of view of developing new prognostic approaches in otosurgery in the management of patients with chronic purulent otitis media, involving the combined use of morphological research methods with microelement analysis of the temporal bone bone tissue.


Asunto(s)
Otitis Media Supurativa , Otitis Media , Adolescente , Adulto , Anciano , Enfermedad Crónica , Oído Medio/diagnóstico por imagen , Oído Medio/cirugía , Humanos , Persona de Mediana Edad , Otitis Media Supurativa/diagnóstico , Otitis Media Supurativa/cirugía , Reproducibilidad de los Resultados , Hueso Temporal/diagnóstico por imagen , Hueso Temporal/cirugía , Adulto Joven
13.
Pan Afr Med J ; 35(Suppl 2): 143, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33193958

RESUMEN

Zimbabwe reported its first case of COVID-19 on 20 March 2020, and since then the number has increased to over 4000. To contain the spread of the causative SARS-CoV-2 and prepare the healthcare system, public health interventions, including lockdowns, were imposed on 30 March 2020. These resulted in disruptions in healthcare provision, and movement of people and supply chains. There have been resultant delays in seeking and accessing healthcare by the patients. Additionally, disruption of essential health services in the areas of maternal and child health, sexual and reproductive health services, care for chronic conditions and access to oncological and other specialist services has occurred. Thus, there may be avoidable excess morbidity and mortality from non-COVID-19 causes that is not justifiable by the current local COVID-19 burden. Measures to restore normalcy to essential health services provision as guided by the World Health Organisation and other bodies needs to be considered and implemented urgently, to avoid preventable loss of life and excess morbidity. Adequate infection prevention and control measures must be put in place to ensure continuity of essential services whilst protecting healthcare workers and patients from contracting COVID-19.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Prestación de Atención de Salud , Pandemias , Neumonía Viral/epidemiología , Enfermedad Crónica/epidemiología , Control de Enfermedades Transmisibles/organización & administración , Continuidad de la Atención al Paciente , Infecciones por Coronavirus/prevención & control , Guías como Asunto , Recursos en Salud/provisión & distribución , Accesibilidad a los Servicios de Salud , Humanos , Pacientes no Asegurados , Medicina , Modelos Teóricos , Mortalidad , Neoplasias/terapia , Pandemias/prevención & control , Aceptación de la Atención de Salud , Equipo de Protección Personal/provisión & distribución , Neumonía Viral/prevención & control , Servicios de Salud Reproductiva/provisión & distribución , Organización Mundial de la Salud , Zimbabwe/epidemiología
14.
Vestn Otorinolaringol ; 85(5): 103-105, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-33140945

RESUMEN

The article describes the clinical case of the cholesteatoma of the temporal bone pyramid, leading to a massive destruction of the surrounding structures. Attention is drawn to the importance of timely diagnosis of this pathology with the use of objective visualization methods to select the optimal surgical approach, which allows to completely remove this formation.


Asunto(s)
Colesteatoma del Oído Medio , Colesteatoma , Otitis Media Supurativa , Colesteatoma/diagnóstico , Colesteatoma/cirugía , Colesteatoma del Oído Medio/diagnóstico , Colesteatoma del Oído Medio/cirugía , Enfermedad Crónica , Humanos , Hueso Temporal/diagnóstico por imagen , Hueso Temporal/cirugía
15.
Yakugaku Zasshi ; 140(11): 1351-1363, 2020.
Artículo en Japonés | MEDLINE | ID: mdl-33132271

RESUMEN

Epidemiological studies have shown that coffee consumption may be associated with a lower risk of developing several chronic disorders. To elucidate the molecular mechanism of the effects of coffee, we analyzed molecular response upon exposure to coffee extract using cellular and animal models of these diseases. As obesity is recognized as a major risk factor for these chronic diseases, we investigated the effect of coffee on adipogenesis using mouse preadipocyte 3T3-L1 cells. We found that coffee induced proteasomal degradation of IRS-1, leading to reduction of PPARγ expression, a master transcription factor for adipogenesis. Reduction in weight as well as in IRS-1 expression was detected in the fat tissues of the high fat-diet-fed mice when reared with 60% coffee for 7 weeks. As for Alzheimer's disease, we analyzed the effect of coffee on amyloid ß (Aß) production in human neuronal SH-SY5Y cells. We found a 20% reduction in Aß production when treated with 2.5% coffee for 2 d. This reduction was due to proteasomal degradation of BACE1 (ß-secretase), which was activated by protein kinase A. In addition, coffee ameliorates LPS-induced inflammatory responses in RAW264.7 macrophages by reducing NFκB activity and Nrf2 activation. Roasted coffee prevents selenite-induced cataractogenesis by ameliorating antioxidant loss. Pyrocatechol, a component of roasted coffee, also reduced Aß production and exhibits anti-inflammatory effects by a similar mechanism as coffee. Our results suggest that roasting coffee beans to generate pyrocatechol is necessary for the preventive effects of coffee intake on the chronic diseases.


Asunto(s)
Enfermedad de Alzheimer/prevención & control , Catarata/prevención & control , Enfermedad Crónica/prevención & control , Café , Ingestión de Líquidos/fisiología , Adipogénesis , Enfermedad de Alzheimer/metabolismo , Secretasas de la Proteína Precursora del Amiloide/metabolismo , Péptidos beta-Amiloides/metabolismo , Animales , Ácido Aspártico Endopeptidasas/metabolismo , Catecoles , Células Cultivadas , Café/química , Modelos Animales de Enfermedad , Manipulación de Alimentos , Calor , Humanos , Proteínas Sustrato del Receptor de Insulina/metabolismo , Ratones , Factor 2 Relacionado con NF-E2/metabolismo , FN-kappa B/metabolismo , PPAR gamma/metabolismo , Complejo de la Endopetidasa Proteasomal/metabolismo , Células RAW 264.7
16.
Rev. bioét. derecho ; (50): 189-203, nov. 2020.
Artículo en Español | IBECS | ID: ibc-191353

RESUMEN

La actual pandemia por la COVID-19 está ocasionado serias amenazas para la salud pública a nivel mundial, especialmente para los grupos de población más vulnerables. Los casos más graves de la enfermedad han sido primeramente atendidos por los profesionales de urgencias y emergencias, los cuales han tenido que tomar decisiones en contextos altamente complejos donde la priorización en la asignación de los recursos sanitarios disponibles les ha generado situaciones éticamente conflictivas. El objetivo del presente artículo es analizar la importancia de implantar la PDA en los servicios de urgencias y emergencias como herramienta de consulta en la resolución de los problemas éticos surgidos durante la pandemia por COVID-19, concretamente, en la atención al paciente crónico complejo o con enfermedad crónica avanzada


The events of the present CoVID-19 pandemic are causing serious threats to Public Health worldwide, specifically at the most vulnerable population groups. Emergency professionals have served as the first responders for the most serious cases of this disease. At the same time, they have made decisions in highly complex contexts where the prioritization of allocated care resources has generated ethically conflictive situations. The aim of this article is to analyze the importance of implementing the ACP as a tool in the emergency services to solve ethical problems that have arisen during the COVID-19 pandemic, particularly in the care of complex chronic patients or those with advanced chronic disease


L'actual pandèmia per la COVID-19 està ocasionat serioses amenaces a la salut pública a nivell mundial, especialment als grups de població més vulnerables. Els casos més greus de la malaltia han estat primerament atesos pels professionals d'urgències I emergències, els quals han hagut de prendre decisions en contextos altament complexos on la priorització en l'assignació dels recursos sanitaris disponibles els ha generat situacions èticament conflictives. L'objectiu d'aquest article va ser analitzar la importància d'implantar la PDA en els serveis d'urgències I emergències com a eina de consulta a la resolució dels problemes ètics sorgits durant la pandèmia per COVID-19, concretament, en l'atenció al pacient crònic complex o amb malaltia crònica avançada


Asunto(s)
Humanos , Prioridades en Salud/ética , Prioridades en Salud/organización & administración , Planificación de Atención al Paciente , Toma de Decisiones/ética , Conflicto de Intereses , Servicios Médicos de Urgencia/ética , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pandemias , Enfermedad Crónica
17.
Afr J Prim Health Care Fam Med ; 12(1): e1-e4, 2020 Nov 05.
Artículo en Inglés | MEDLINE | ID: mdl-33181873

RESUMEN

Cape Town is currently one of the hotspots for COVID-19 on the African continent. The Metropolitan Health Services have re-organised their primary health care (PHC) services to tackle the epidemic with a community-orientated primary care perspective. Two key goals have guided the re-organisation, the need to maintain social distancing and reduce risk to people using the services and the need to prepare for an influx of people with COVID-19. Facilities were re-organised to have 'screening and streaming' at the entrance and patients were separated into hot and cold streams. Both streams had 'see and treat' stations for the rapid treatment of minor ailments. Patients in separate streams were then managed further. If patients with chronic conditions were stable, they were provided with home delivery of medication by community health workers. Community health workers also engaged in community-based screening and testing. Initial evaluation of PHC preparedness was generally good. However, a number of key issues were identified. Additional infrastructure was required in some facilities to keep the streams separate with the onset of winter. Managers had to actively address the anxiety and fears of the primary care workforce. Attention also needed to be given to the prevention and treatment of non-COVID conditions as utilisation of these services decreased. The epidemic exposed intersectoral and intrasectoral fault lines, particularly access to social services at a time when they were most needed. Community screening and testing had to be refocused due to limited laboratory capacity and a lengthening turnaround time.


Asunto(s)
Servicios de Salud Comunitaria/métodos , Infecciones por Coronavirus/terapia , Prestación de Atención de Salud/métodos , Instituciones de Salud , Planificación en Salud , Pandemias , Neumonía Viral/terapia , Atención Primaria de Salud/métodos , Betacoronavirus , Enfermedad Crónica , Ciudades , Agentes Comunitarios de Salud , Coronavirus , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Epidemias , Personal de Salud , Accesibilidad a los Servicios de Salud , Humanos , Tamizaje Masivo , Organizaciones , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Neumonía Viral/virología , Estaciones del Año , Sudáfrica/epidemiología , Triaje
20.
Monaldi Arch Chest Dis ; 90(4)2020 Nov 09.
Artículo en Inglés | MEDLINE | ID: mdl-33169599

RESUMEN

The pandemic of COVID-19 has emerged as a serious health crisis globally and India too has been extensively affected with 604,641 active cases reported, till date. The present study focuses on the demographic, clinical and laboratory profile of such patients from a tertiary level non-COVID respiratory care hospital. This is a retrospective observational study. Seventy-seven sick patients fulfilling COVID suspect criteria were admitted to the isolation area. Their RT-PCR test was done from the designated laboratory and 35 of them  were confirmed to be COVID-19 patients. The detailed demographic, clinical and laboratory profile of these COVID-19 patients was studied. The mean age was 46±17 years with male predominance (57%). Majority  of the cases (83%) were symptomatic. The most common symptom was cough (66%) followed by breathlessness and fever. Nineteen (54.3%) patients had one or the other co-morbidity and 16 (45.7%) had chronic lung diseases as one of the comorbidities. Nearly half of the patients (51%) required supplementary oxygen on presentation. Two patients were put on invasive mechanical ventilation while 4 patients required non-invasive ventilation before being shifted to the COVID hospital. Hence, it can be concluded that COVID-19 in patients of chronic respiratory diseases  manifests with higher prevalence of symptoms and also higher severity of disease. Further, the  symptomatology of COVID-19 closely mimics the acute exacerbation of chronic lung diseases, so cautious screening and testing should be done, especially at the pulmonary department.


Asunto(s)
Infecciones por Coronavirus/fisiopatología , Diabetes Mellitus/epidemiología , Hospitales Especializados , Hipertensión/epidemiología , Hipoxia/fisiopatología , Enfermedades Pulmonares/epidemiología , Neumonía Viral/fisiopatología , Neumología , Centros de Atención Terciaria , Adulto , Asma/epidemiología , Betacoronavirus , Bronquiectasia/epidemiología , Enfermedad Crónica , Comorbilidad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Tos/fisiopatología , Disnea/fisiopatología , Femenino , Fiebre/fisiopatología , Humanos , India/epidemiología , Enfermedades Pulmonares Intersticiales/epidemiología , Masculino , Persona de Mediana Edad , Ventilación no Invasiva , Terapia por Inhalación de Oxígeno , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Respiración Artificial , Estudios Retrospectivos
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