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J. Health NPEPS ; 6(1)jun. 2021.
Artículo en Portugués | LILACS | ID: biblio-1147344


Objetivo: analisar a letalidade da COVID-19 por sexo e idade entre os profissionais de saúde do Estado Pará, Brasil. Método: estudo epidemiológico e observacional, com utilização de dados secundários públicos sobre casos e óbitos acumulados por COVID-19 e dados demográficos, entre março e outubro de 2020. O número de casos e óbitos por COVID-19 ocorridos entre profissionais de saúde foram comparados em relação à idade e ao sexo pelo teste qui-quadrado, seguido por regressão logística pelo método Backward Stepwise de Wald. Resultados: entre os 15.332 casos confirmados de COVID-19, 70,3% eram do sexo feminino e 61,3% com idade entre 30 a 49 anos (39,2±11,6 anos). Registraram-se 97 óbitos, com uma taxa de letalidade de 0,6%. A probabilidade de óbito foi 52,8 vezes (20,7-134,5) e 4,0 vezes (2,5-6,2) maior entre jovens e homens quando comparados às demais notificações. Conclusão: a taxa de letalidade entre os profissionais de saúde é alta, especialmente entre homens jovens. Este é um alerta sobre os impactos da doença entre os trabalhadores da saúde e suscita ao poder público, especificamente ao setor saúde melhores condições de trabalho e políticas de saúde do trabalhador.(AU)

Objective: to analyze the lethality of COVID-19 by sex and age among health professionals in the state of Pará, Brazil. Method: epidemiological and observational study, using public secondary data on cases and deaths accumulated by COVID-19 and demographic data, between March and October 2020. The number of cases and deaths by COVID-19 that occurred among health professionals were compared in relation to age and sex using the chi-square test, followed by logistic regression using Wald's Backward Stepwise method. Results: among the 15,332 confirmed cases of COVID-19, 70.3% were female and 61.3% aged between 30 and 49 years (39.2 ± 11.6 years). 97 deaths were recorded, with a fatality rate of 0.6%. The probability of death was 52.8 times (20.7-134.5) and 4.0 times (2.5-6.2) higher among young men and men when compared to other reports. Conclusion: the lethality rate among health professionals is high, especially among young men. This is an alert about the impacts of the disease among health workers and raises the public authorities, specifically the health sector, better working conditions and worker health policies.(AU)

Objetivo: analizar la letalidad de COVID-19 por sexo y edad en profesionales de la salud en el estado de Pará, Brasil. Método: estudio epidemiológico y observacional, utilizando datos secundarios públicos sobre casos y defunciones acumulados por COVID-19 y datos demográficos, entre marzo y octubre de 2020. Se comparó el número de casos y defunciones por COVID-19 ocurridos entre profesionales de la salud en relación con edad y sexo usando la prueba de chi-cuadrado, seguida de regresión logística usando el método de Wald Backward Stepwise. Resultados: entre los 15.332 casos confirmados de COVID-19, el 70,3% eran mujeres y el 61,3% tenían entre 30 y 49 años (39,2 ± 11,6 años). Se registraron 97 muertes, con una tasa de letalidad del 0,6%. La probabilidad de muerte fue 52,8 veces (20,7-134,5) y 4,0 veces (2,5-6,2) más grande entre hombres y jóvenes en comparación con otros informes. Conclusión: la tasa de letalidad entre los profesionales de la salud es alta, especialmente entre los hombres jóvenes. Se trata de una alerta sobre los impactos de la enfermedad entre los trabajadores de la salud y plantea a las autoridades públicas, específicamente al sector salud, mejores condiciones laborales y políticas de salud laboral.(AU)

Humanos , Salud Laboral , Personal de Salud/estadística & datos numéricos , Infecciones por Coronavirus/mortalidad , Política de Salud , Brasil , Estudios Epidemiológicos
BMC Psychol ; 9(1): 42, 2021 Mar 09.
Artículo en Inglés | MEDLINE | ID: mdl-33750473


BACKGROUND: Recently, extensive research has been reported the higher rate of depression and anxiety among people living with HIV/AIDS (PLWHAs) as compared to the general population. However, no single study has been carried out to investigate whether this disparity is a real difference or it happens due to lack of measurement invariance. This study aims to assess the measurement invariance of the Beck Anxiety Inventory (BAI) and 10-item Centre for Epidemiological Studies Depression Scale (CESD-10) questionnaires across PLWHAs and healthy individuals. METHODS: One hundred and fifty PLWHAs and 500 healthy individuals filled out the Persian version of the BAI and CESD-10 questionnaires. Multi-group multiple-indicators multiple-causes model (MG-MIMIC) was used to assess measurement invariance across PLWHAs and healthy people. RESULTS: Our findings revealed that PLWHAs and healthy individuals perceived the meaning of all the items in the BAI and CESD-10 questionnaires similarly. In addition, although depression scores were significantly higher in PLWHAs as opposed to the healthy individuals, no significant difference was observed in anxiety scores of these two groups. CONCLUSIONS: The current study suggests that the BAI and CESD-10 are invariant measures across PLWHAs and healthy people which can be used for meaningful cross-group comparison. Therefore, in comparison to healthy individuals, higher depression score of PLWHAs is a real difference. It is highly recommended that health professionals develop therapeutic interventions and psychological supports to promote the mental health of PLWHAs which alleviate their depressive symptoms.

Depresión , Infecciones por VIH , Ansiedad/diagnóstico , Ansiedad/epidemiología , Depresión/diagnóstico , Depresión/epidemiología , Estudios Epidemiológicos , Infecciones por VIH/epidemiología , Humanos , Encuestas y Cuestionarios
J Nutr Health Aging ; 25(3): 369-373, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33575730


OBJECTIVES: During the 2019 coronavirus disease (COVID-19) outbreak, malnutrition may contribute to COVID-19 adverse outcomes. We conducted a clinical epidemiological analysis to investigate the association of malnutrition with hospitalized duration in patients with COVID-19. DESIGN: Retrospective survey study. SETTING: Taikang Tongji (Wuhan) hospital in Wuhan, China. PARTICIPANTS: 139 patients with COVID-19. METHODS: In total, 139 patients with COVID-19 from patients in the Infection Department of Taikang Tongji (Wuhan) hospital from February 2020 to April 2020 were analyzed retrospectively. We used the "Global leadership Initiative on Malnutrition(GLIM)" assessment standard published in 2019 to assess nutritional status. Prolonged hospitalization was lasting more than the median value of the hospitalized days (17 days) in this population. RESULTS: According to the assessment results of GLIM nutrition assessment, the patients were divided into malnutrition group and normal nutrition group. Compared with the patients in the normal nutrition group, the hospitalization time was longer(15.67±6.26 days versus 27.48±5.04 days, P = 0.001). Kaplan-Meier analysis showed patients with malnutrition were more likely to be hospitalized longer compared with those normal nutrition (mean with 95% confidence interval [CI]: 28.91[27.52-30.30] versus 22.78[21.76-23.79], P = 0.001). COX regression analysis showed that malnutrition (hazard ratio [HR] = 3.773, P for trend = 0.001) was proportional associated with being discharged from hospital delayed. CONCLUSION AND IMPLICATIONS: Present findings suggested that malnutrition contributed to predicting a probability of prolonged hospitalization in patients with COVID-19 infection, to whom extra attentions and precautions should be paid during clinical treatments. Based on the existing results, it is recommended that inpatients with nutritional risk or malnutrition start nutritional support treatment as soon as possible.

/epidemiología , Infecciones por Coronavirus/epidemiología , Desnutrición/epidemiología , Anciano , China/epidemiología , Infecciones por Coronavirus/complicaciones , Estudios Epidemiológicos , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Desnutrición/virología , Persona de Mediana Edad , Estudios Retrospectivos
Rev Bras Epidemiol ; 24: e210010, 2021.
Artículo en Portugués, Inglés | MEDLINE | ID: mdl-33605304


OBJECTIVE: To describe the methodological and operational aspects of an epidemiological and an evaluation of Rede Cegonha in Santa Catarina, Brazil. METHODS: The research carried out in 2019 was composed of two sub-studies. Regarding the first, whose design was epidemiological and analyzed prenatal, delivery and immediate puerperium care addressed to pregnant women, puerperal women and children assisted at SUS, the instruments used for data collection and the organization of the field of the study are described. The other sub-study was a normative assessment of municipal management in prenatal and postpartum care within the scope of Rede Cegonha. It began with an evaluability assessment followed by the assessment itself. The different methodological strategies adopted are described, with the involvement of stakeholders and experts. RESULTS: The response rate of the epidemiological sub-study was 97.7%. Women residing in 82.7% of Santa Catarina's municipalities were interviewed. The sample was similar to that registered in SINASC for the same period, and the characteristics of the sub-sample interviewed after six months was similar to the global sample. The evaluation study improved and applied a model with 32 indicators that allowed to analyze the municipalities considering the political-organizational and tactical-operational aspects. Two hundred and four municipalities answered the questionnaire (69.1%); they were evaluated according to their respective population size. CONCLUSION: The availability of methodological procedures of studies that articulate epidemiological and evaluation methods allows generating more accurate and complete information and contribute with the design and evaluation of health policies, programs and actions.

Estudios Epidemiológicos , Estudios de Evaluación como Asunto , Proyectos de Investigación , Brasil/epidemiología , Niño , Femenino , Humanos , Servicios de Salud Materno-Infantil , Embarazo , Encuestas y Cuestionarios
Lancet Public Health ; 6(4): e222-e231, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33556327


BACKGROUND: The objective of this study was to better understand the factors associated with the heterogeneity of in-hospital COVID-19 morbidity and mortality across France, one of the countries most affected by COVID-19 in the early months of the pandemic. METHODS: This geo-epidemiological analysis was based on data publicly available on government and administration websites for the 96 administrative departments of metropolitan France between March 19 and May 11, 2020, including Public Health France, the Regional Health Agencies, the French national statistics institute, and the Ministry of Health. Using hierarchical ascendant classification on principal component analysis of multidimensional variables, and multivariate analyses with generalised additive models, we assessed the associations between several factors (spatiotemporal spread of the epidemic between Feb 7 and March 17, 2020, the national lockdown, demographic population structure, baseline intensive care capacities, baseline population health and health-care services, new chloroquine and hydroxychloroquine dispensations, economic indicators, degree of urbanisation, and climate profile) and in-hospital COVID-19 incidence, mortality, and case fatality rates. Incidence rate was defined as the cumulative number of in-hospital COVID-19 cases per 100 000 inhabitants, mortality rate as the cumulative number of in-hospital COVID-19 deaths per 100 000, and case fatality rate as the cumulative number of in-hospital COVID-19 deaths per cumulative number of in-hospital COVID-19 cases. FINDINGS: From March 19 to May 11, 2020, hospitals in metropolitan France notified a total of 100 988 COVID-19 cases, including 16 597 people who were admitted to intensive care and 17 062 deaths. There was an overall cumulative in-hospital incidence rate of 155·6 cases per 100 000 inhabitants (range 19·4-489·5), in-hospital mortality rate of 26·3 deaths per 100 000 (1·1-119·2), and in-hospital case fatality rate of 16·9% (4·8-26·2). We found clear spatial heterogeneity of in-hospital COVID-19 incidence and mortality rates, following the spread of the epidemic. After multivariate adjustment, the delay between the first COVID-19-associated death and the onset of the national lockdown was positively associated with in-hospital incidence (adjusted standardised incidence ratio 1·02, 95% CI 1·01-1·04), mortality (adjusted standardised mortality ratio 1·04, 1·02-1·06), and case fatality rates (adjusted standardised fatality ratio 1·01, 1·01-1·02). Mortality and case fatality rates were higher in departments with older populations (adjusted standardised ratio for populations with a high proportion older than aged >85 years 2·17 [95% CI 1·20-3·90] for mortality and 1·43 [1·08-1·88] for case fatality rate). Mortality rate was also associated with incidence rate (1·0004, 1·0002-1·001), but mortality and case fatality rates did not appear to be associated with baseline intensive care capacities. We found no association between climate and in-hospital COVID-19 incidence, or between economic indicators and in-hospital COVID-19 incidence or mortality rates. INTERPRETATION: This ecological study highlights the impact of the epidemic spread, national lockdown, and reactive adaptation of intensive care capacities on the spatial distribution of COVID-19 morbidity and mortality. It provides information for future geo-epidemiological analyses and has implications for preparedness and response policies to current and future epidemic waves in France and elsewhere. FUNDING: None.

/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Estudios Epidemiológicos , Femenino , Francia/epidemiología , Geografía Médica , Mortalidad Hospitalaria/tendencias , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Factores de Riesgo , Análisis Espacial
Ann Hematol ; 100(4): 1003-1012, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33587155


Chimeric antigen receptor (CAR) T cell therapy improves the remission rate of refractory/relapsed B-acute lymphoblastic leukemia (R/R B-ALL) patients, but the relapse rate remains high. Recent studies suggest patients who underwent post-chimeric antigen receptor T cell therapy hematopoietic stem cell transplantation (post- HSCT) would achieve durable remission and better survival, but this remains controversial. To this end, we conducted a meta-analysis to assess the role of post-HSCT in R/R B-ALL. The Cochrane Library, Embase, and PubMed were used to identify relevant studies; the latest search update was on July 05, 2020. We used the Cochran Q test and I-squared statistics to test for heterogeneity among the studies analyzed. The fixed model and random model were used to combine results when appropriate. We performed all statistical analyses with Stata 12, and P < 0.05 was considered statistically significant. We included 18 studies with 758 patients in the meta-analysis. Our results indicated that post-HSCT was associated with lower relapse rate (RR: 0.40, 95% CI: 0.32-0.50, P = 0.000), better overall survival (HR: 0.37, 95% CI: 0.19-0.71, P = 0.003), better leukemia-free survival (HR: 0.20, 95% CI: 0.10-0.40, P = 0.000). However, post-HSCT did not influence OS in Caucasians, and CAR-T cells with CD28 co-stimulation factor bridged to HSCT did not influence OS. Post-HSCT decreased the relapse rate and improved the long-term survival of R/R B-ALL patients. R/R B-ALL patients would benefit from post-HSCT after CAR-T cell therapy.

Trasplante de Células Madre Hematopoyéticas , Inmunoterapia Adoptiva , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Terapia Recuperativa , Antígenos CD19/inmunología , Grupo de Ascendencia Continental Asiática , Supervivencia sin Enfermedad , Estudios Epidemiológicos , Grupo de Ascendencia Continental Europea , Humanos , Leucemia-Linfoma Linfoblástico de Células Precursoras/etnología , Leucemia-Linfoma Linfoblástico de Células Precursoras/mortalidad , Pronóstico , Recurrencia , Inducción de Remisión , Resultado del Tratamiento
JMIR Public Health Surveill ; 7(3): e24696, 2021 03 02.
Artículo en Inglés | MEDLINE | ID: mdl-33522974


BACKGROUND: SARS-CoV-2 and influenza are lipid-enveloped viruses with differential morbidity and mortality but shared modes of transmission. OBJECTIVE: With a descriptive epidemiological framing, we assessed whether recent historical patterns of regional influenza burden are reflected in the observed heterogeneity in COVID-19 cases across regions of the world. METHODS: Weekly surveillance data reported by the World Health Organization from January 2017 to December 2019 for influenza and from January 1, 2020 through October 31, 2020, for COVID-19 were used to assess seasonal and temporal trends for influenza and COVID-19 cases across the seven World Bank regions. RESULTS: In regions with more pronounced influenza seasonality, COVID-19 epidemics have largely followed trends similar to those seen for influenza from 2017 to 2019. COVID-19 epidemics in countries across Europe, Central Asia, and North America have been marked by a first peak during the spring, followed by significant reductions in COVID-19 cases in the summer months and a second wave in the fall. In Latin America and the Caribbean, COVID-19 epidemics in several countries peaked in the summer, corresponding to months with the highest influenza activity in the region. Countries from regions with less pronounced influenza activity, including South Asia and sub-Saharan Africa, showed more heterogeneity in COVID-19 epidemics seen to date. However, similarities in COVID-19 and influenza trends were evident within select countries irrespective of region. CONCLUSIONS: Ecological consistency in COVID-19 trends seen to date with influenza trends suggests the potential for shared individual, structural, and environmental determinants of transmission. Using a descriptive epidemiological framework to assess shared regional trends for rapidly emerging respiratory pathogens with better studied respiratory infections may provide further insights into the differential impacts of nonpharmacologic interventions and intersections with environmental conditions. Ultimately, forecasting trends and informing interventions for novel respiratory pathogens like COVID-19 should leverage epidemiologic patterns in the relative burden of past respiratory pathogens as prior information.

/epidemiología , Costo de Enfermedad , Salud Global/estadística & datos numéricos , Gripe Humana/epidemiología , Estudios Epidemiológicos , Humanos
Arch Osteoporos ; 16(1): 17, 2021 01 21.
Artículo en Inglés | MEDLINE | ID: mdl-33479804


Osteoporosis is a disease with a high burden of morbidity. For its accurate diagnosis, using indigenous data as reference standards is needed. However, normative data on bone density is lacking in India. Therefore, we aimed to determine the reference range for bone density for the healthy population of north India. INTRODUCTION: Osteoporosis is a major public health problem around the globe including India, resulting in significant morbidity, mortality, and health care burden. However, the reference values used for its diagnosis are largely based on data from the western population, which may lead to over- or underdiagnosis of osteoporosis in Indians. Our study aimed to determine the reference range for bone mineral density for the healthy population of India. METHODS: This is a cross-sectional study of 825 subjects (men 380, women 445) (median age: 41 years, IQR 32-55 years), recruited by a house-to-house survey. The population was stratified into decade-wise groups and biochemical measurements including renal and liver function tests, glycated hemoglobin, serum calcium, 25-hydroxyvitamin D, parathyroid hormone, and bone mineral density were performed in all the subjects. The T-scores for men aged > 50 years and post-menopausal women were calculated based on the data generated from this study in young men and women aged 20-40 years. RESULTS: According to the BMD manufacturer's data, which is based on the western population, 70% of the Indian men (> 50 years) and 48% of the post-menopausal Indian women had osteopenia while 18% of the men and 25% of the women had osteoporosis. However, according to the re-calculated T-scores from the current study, only 56% and 7.2% of men and 33% and 5% of women had osteopenia and osteoporosis, respectively. An age-related decline in bone mineral density, as seen in the western population, was also seen in both Indian men and women. CONCLUSION: We have established a reference database for BMD in healthy Indian adult population, which may have clinical implications for the diagnosis and intervention strategies for the management of osteoporosis.

Densidad Ósea , Osteoporosis , Absorciometría de Fotón , Adulto , Estudios Transversales , Estudios Epidemiológicos , Femenino , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Osteoporosis/diagnóstico por imagen , Osteoporosis/epidemiología , Adulto Joven
Rev. enferm. UFPE on line ; 15(1): [1-12], jan. 2021. ilus, tab, graf
Artículo en Portugués | BDENF - Enfermería | ID: biblio-1145757


Objetivo: analisar a taxa de mortalidade infantil no Brasil, por regiões. Método: trata-se de um estudo quantitativo, descritivo, retrospectivo, epidemiológico, transversal. Compôs-se a amostra por todos os nascidos vivos e óbitos de crianças menores de um ano registrados no SINASC e SIM, respectivamente. Obtiveram-se os dados por meio da plataforma digital DATASUS. Resultados: registraram-se 128.332 óbitos infantis na região Nordeste durante esse período, tendo como seus principais fatores a idade materna menor de 14 anos, mães sem escolaridade, gestações com duração de 22 a 27 semanas, crianças nascidas de parto vaginal, sexo masculino, cor/raça indígena, peso ao nascer menor que 999 gramas e baixa atenção à mulher na gestação. Conclusão: concluiuse que grande parte dos óbitos infantis no Nordeste está ligada a causas maternas, evidenciando-se falha na assistência de saúde. Podem-se alterar esses números por meio de uma assistência prénatal adequada, planejamento familiar e qualificação da promoção de saúde.(AU)

Objective: to analyze the infant mortality rate in Brazil, by regions. Method: it is a quantitative, descriptive, retrospective, epidemiological, cross-sectional study. The sample was composed by all live births and deaths of children under one year of age registered in SINASC and YES, respectively. The data were obtained through the DATASUS digital platform. Results: there were 128,332 infant deaths in the Northeast region during this period, the main factors being maternal age under 14, mothers without schooling, pregnancies lasting from 22 to 27 weeks, children born vaginally, male, indigenous color/race, weight at birth less than 999 grams and low attention to women in pregnancy. Conclusion: It was concluded that a large part of the childhood deaths in the Northeast are linked to maternal causes, showing a failure in health care. These numbers can be changed through adequate prenatal care, family planning and health promotion qualification.(AU)

Objetivo: analizar la tasa de mortalidad infantil en Brasil, por región. Método: se trata de un estudio cuantitativo, descriptivo, retrospectivo, epidemiológico, transversal. La muestra estuvo compuesta por todos los nacidos vivos y defunciones de niños menores de un año registrados en SINASC y SIM, respectivamente. Los datos se obtuvieron utilizando la plataforma digital DATASUS. Resultados: se registraron 128,332 muertes infantiles en la región Noreste durante este período, siendo los principales factores la edad materna menor de 14 años, madres sin educación, embarazos de 22 a 27 semanas, niños nacidos por parto vaginal, varones, color / raza indígena, peso al nacer menor a 999 gramos y poca atención a la mujer durante el embarazo. Conclusión: se concluyó que gran parte de las muertes infantiles en el Noreste está relacionada a causas maternas, evidenciando una falla en la atención de salud. Estos números pueden modificarse mediante una atención prenatal adecuada, planificación familiar y calificación de la promoción de la salud.(AU)

Humanos , Masculino , Femenino , Recién Nacido , Lactante , Brasil , Mortalidad Infantil , Registros de Mortalidad , Salud Pública , Factores de Riesgo , Sistemas de Información en Salud , Estudios Epidemiológicos , Epidemiología Descriptiva , Estudios Transversales , Estudios Retrospectivos
Zhonghua Liu Xing Bing Xue Za Zhi ; 42(1): 10-14, 2021 Jan 10.
Artículo en Chino | MEDLINE | ID: mdl-33503693


Recent years with the rapid progress in high-throughput omics techniques, the accumulation of population cohorts and biobanks, great advances in internet and information technology, and the emerging tools for big data utilization, health care big data provide abundant data resources and broad research platforms for epidemiological research. We aimed to review the opportunities and challenges of epidemiological research in the era of big data, and explore the future development of epidemiology. Epidemiology should seize the opportunities, open up new directions, develop new methods, and promote the translation of research results into public health and clinical medicine, which will eventually realize the vision of "Healthy China".

Macrodatos , China/epidemiología , Estudios Epidemiológicos , Humanos , Estudios Prospectivos
Nurs Health Sci ; 23(1): 245-254, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33438833


The purpose of this study of healthcare workers who cared for COVID-19 patients was to identify factors that affected the duration of wearing personal protective equipment (PPE). The results of this study will provide initial guidance to practicing clinicians and a foundation for further research on this topic. This cross-sectional study examined 139 frontline healthcare professionals who worked at a single hospital in Wuhan, China, from March 16 to April 1, 2020. General and demographic data, physical and mental status, use of personal protective equipment, type of hospital work, and duration of wearing personal protective equipment were recorded. The mean duration of wearing personal protective equipment was 194.17 min (standard deviation: 3.71). Multiple linear regression analysis indicated that the duration of wearing personal protective equipment was significantly associated with the presence of a chronic disease, working hours when feeling discomfort, lack of patient cooperation and subsequent psychological pressure, prolonged continuous wearing of personal protective equipment, feeling anxious about physical strength, and the presence of fatigue when wearing personal protective equipment. These factors should be considered by practicing healthcare professionals and in future studies that examine the optimal duration of wearing personal protective equipment.

/terapia , Equipos Desechables/estadística & datos numéricos , Personal de Salud/psicología , Equipo de Protección Personal/estadística & datos numéricos , Adulto , Actitud del Personal de Salud , China , Estudios Transversales , Estudios Epidemiológicos , Femenino , Personal de Salud/estadística & datos numéricos , Humanos , Masculino , Pandemias , Equipo de Protección Personal/efectos adversos , Equipo de Protección Personal/clasificación , Encuestas y Cuestionarios , Factores de Tiempo
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 13: 57-64, jan.-dez. 2021. tab
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1146077


Objetivo: analisar o perfil de utilização de medicamentos por hipertensos e/ou diabéticos de uma Estratégia de Saúde da Família do Sul de Mato Grosso. Métodos: trata-se de uma pesquisa quantitativa e transversal com usuários cadastrados em uma Unidade Básica de Saúde. Os dados foram coletados em visitas domiciliares. Resultados: os usuários consumiram uma média de 2,9 medicamentos. Não houve diferença estatística no consumo médio de medicamentos entre homens e mulheres. Os idosos utilizavam mais medicamentos. Os fármacos que atuam no sistema cardiovascular foram os mais consumidos. Conclusão: os resultados apontam para a necessidade da promoção do uso racional de medicamentos, sobretudo na população idosa

Objective: to analyze the profile of drug use by hypertensive and diabetic people from a Family Health Strategy of Southern Mato Grosso. Methods: this is a quantitative and cross-sectional research with users registered at a Basic Health Unit. The data were collected in home visits. Results: the users consumed an average of 2.9 drugs. There was no statistical difference in the mean consumption between men and women. The elders used more drugs. The most used drugs were the ones that work in the cardiovascular system. Conclusion: the results show the need for promoting the rational use of drugs, especially in the elderly population

Objetivo: analizar el perfil de utilización de medicamentos por hipertensos y/o diabéticos de una Estrategia de Salud de la Familia del Sur de Mato Grosso. Métodos: se trata de una investigación cuantitativa y transversal con usuarios registrados en una Unidad Básica de Salud. Los datos fueron colectados en visitas domiciliarias. Resultados: los usuarios consumieron una media de 2,9 medicamentos. No habia diferencia estadística en el consumo medio de medicamentos entre hombres y mujeres. Los ancianos utilizaban más medicamentos. Los fármacos que actúan en el sistema cardiovascular fueron los más consumidos. Conclusión: los resultados apuntan a la necesidad de la promoción del uso racional de medicamentos, sobre todo en la población anciana

Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Estrategia de Salud Familiar , Diabetes Mellitus/tratamiento farmacológico , Utilización de Medicamentos/estadística & datos numéricos , Hipertensión/tratamiento farmacológico , Estudios Epidemiológicos , Visita Domiciliaria , Hipertensión
Rev. latinoam. enferm. (Online) ; 29: e3401, 2021. tab
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1150008


Objective: to compare the sociodemographic and economic characteristics of the older adults in the community according to the living arrangement and to verify the association between the type of living arrangement and the quality of life scores. Method: a cross-sectional epidemiological study conducted with 796 older adults in the community. To assess quality of life (dependent variable), network and social support (adjustment variable), validated and applied chi-square tests, descriptive statistical analysis, multiple comparison analysis (ANOVA) and multiple linear regression model (p<0.05) were used. Results: the older adults who lived only with their spouses had better quality of life scores in all domains and facets, except in the death and dying domain, which did not show any significant difference. The lowest scores for quality of life were identified in the groups with the presence of children and, exceptionally, in the domain of social relationships and, in the facets death and dying and intimacy, those who lived alone had worse assessments. In the adjusted model, there was an association between the type of living arrangement and the different domains and facets of quality of life. Conclusion: living arrangement was associated with quality of life scores for older adults in the community, even after adjusting for the gender, age, number of morbidities, and social support variables.

Objetivo: comparar as características sociodemográficas e econômicas de idosos da comunidade segundo o arranjo domiciliar e verificar associação entre o tipo de arranjo domiciliar e os escores de qualidade de vida. Método: estudo epidemiológico transversal, com 796 idosos da comunidade. Para avaliar qualidade de vida (variável dependente), rede e apoio social (variável de ajuste), foram utilizados instrumentos validados e aplicados teste qui-quadrado, análise estatística descritiva, análise de comparações múltiplas (ANOVA) e modelo de regressão linear múltipla (p<0,05). Resultados: os idosos que residiam somente com os cônjuges apresentaram melhores escores de qualidade de vida em todos os domínios e facetas, exceto no domínio morte e morrer, que não evidenciou diferença significativa. Os menores escores de qualidade de vida foram identificados nos grupos com a presença dos filhos, sendo que, excepcionalmente no domínio relações sociais e nas facetas morte e morrer e intimidade, aqueles que viviam sozinhos tiveram piores avaliações. No modelo ajustado, verificou-se associação entre o tipo de arranjo domiciliar e os diferentes domínios e facetas de qualidade de vida. Conclusão: o arranjo domiciliar apresentou associação com escores de qualidade de vida de idosos da comunidade, mesmo após ajuste para as variáveis sexo, idade, número de morbidades e apoio social.

Objetivo: comparar las características sociodemográficas y económicas de los adultos mayores de la comunidad según la conformación domiciliaria y verificar la asociación entre el tipo de conformación domiciliaria y los puntajes de calidad de vida. Método: estudio epidemiológico transversal con 796 ancianos de la comunidad. Para evaluar la calidad de vida (variable dependiente), la red y el apoyo social (variable de ajuste), se utilizaron instrumentos validados y aprobados, pruebas de chi-cuadrado, análisis estadístico descriptivo, análisis de comparación múltiple (ANOVA) y modelo de regresión lineal múltiple (p<0,05). Resultados: los adultos mayores que vivían solamente con sus cónyuges obtuvieron mejores puntajes de calidad de vida en todos los dominios y facetas, excepto en el dominio muerte y morir, que no mostró diferencia significativa. Los puntajes más bajos en calidad de vida se identificaron en los grupos con presencia de hijos y, de manera excepcional en el dominio de las relaciones sociales y en las facetas muerte y morir e intimidad, aquellos que vivían solos tuvieron peores evaluaciones. En el modelo ajustado, se verificó asociación entre el tipo de conformación domiciliaria y los diferentes dominios y facetas de calidad de vida. Conclusión: la conformación domiciliaria se asoció con puntajes de calidad de vida de los adultos mayores de la comunidad, incluso después del ajuste por las variables sexo, edad, número de morbilidades y apoyo social.

Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Calidad de Vida , Ajuste Social , Apoyo Social , Estudios Epidemiológicos , Características de la Residencia , Composición Familiar , Análisis de Varianza , Morbilidad , Muerte , Identidad de Género , Enfermería Geriátrica , Relaciones Interpersonales
Sci Total Environ ; 752: 141824, 2021 Jan 15.
Artículo en Inglés | MEDLINE | ID: mdl-32896789


Chromium (Cr) can coexist with other heavy metals in the blood of chronically chromate-exposed individuals. However, few studies have explored the health impacts of other hazardous metals after exposure to hexavalent chromium [Cr(VI)]. This study aimed to assess the modification effects of blood lead (Pb) on the genetic damage induced by Cr(VI). During 2010-2019, 1000 blood samples were collected from 455 workers exposed to chromate and 545 workers not exposed to chromate from the same factory with similar labor intensity. The levels of Cr and Pb were measured in whole blood samples. Micronucleus frequency (MNF) and urinary 8-hydroxydeoxyguanosine (8-OHdG) were measured to reflect different types of genetic damage. Multivariate linear regression analyses were performed to evaluate the associations between hazardous metals and the modification effects of Pb on genetic damage. The geometric mean levels of Cr and Pb in the exposure group were significantly higher than those in the control group [Cr: 6.42 (6.08- 6.79) vs. 1.29 (1.22- 1.36) µg/L; Pb: 38.82 (37.22- 40.50) vs. 34.47 (33.15- 35.85) µg/L]. The geometric means of urinary 8-OHdG and MNF in exposure group were 4.00 (3.64- 4.40) µg/g and 5.40 (4.89- 5.97) ‰, respectively, significantly higher than the 3.20 (2.94- 3.48) µg/g and 4.57 (4.15- 5.03) ‰, respectively, in control group. log2Cr was independently and positively associated with urinary 8-OHdG (ß-adjusted = 0.143, 95% CI: 0.082- 0.204) and MNF (ß-adjusted = 0.303, 95%CI: 0.020- 0.587). With the change in circulating Pb levels, the types of genetic damage induced by Cr(VI) were different. At low levels of circulating Pb (<30.80 µg/L), chromate mainly caused changes in 8-OHdG, while at high circulating Pb levels (≥44.88 µg/L), chromate induced alterations in MNF. The findings suggested that chromate exposure could cause multiple types of genetic damage, and circulating Pb might modify the association between circulating Cr and the form of genetic damage.

Cromatos , Exposición Profesional , Cromatos/toxicidad , Cromo/toxicidad , Estudios Epidemiológicos , Humanos , Plomo/toxicidad , Exposición Profesional/análisis
Arch. argent. pediatr ; 118(6): 386-392, dic 2020. tab, ilus
Artículo en Inglés, Español | LILACS, BINACIS | ID: biblio-1146049


Introducción. El virus sincicial respiratorio (VSR) es el principal agente causal de la infección respiratoria aguda baja (IRAB) en pediatría. Los niños prematuros tienen mayor riesgo de complicaciones asociadas con esta infección. Los objetivos fueron describir y comparar las características clínicas y epidemiológicas asociadas a IRAB por VSR en niños/as nacidos pretérmino y a término, y establecer predictores de letalidad en los prematuros.Métodos. Estudio prospectivo, transversal, de pacientes ingresados por IRAB, en el período 2000-2018. El diagnóstico virológico se realizó mediante inmunofluorescencia indirecta o reacción en cadena de la polimerasa con transcriptasa inversa de aspirados nasofaríngeos. Se registraron las características clínico-epidemiológicas. Se desarrolló un modelo de regresión logística múltiple para establecer los predictores de letalidad en prematuros.Resultados. Se incluyeron 16 018 casos de IRAB; 13 545 (el 84,6 %) fueron estudiados; 6047 (el 45 %) positivos; VSR predominó en el 81,1 % (4907); mostró un patrón epidémico estacional; el 14 % (686) fueron prematuros.Los prematuros mostraron mayor frecuencia de comorbilidades, antecedentes respiratorios perinatales, cardiopatía congénita, desnutrición, enfermedad respiratoria crónica, displasia broncopulmonar, hospitalización previa por IRAB y enfermedad neurológica crónica (p < 0,001); requirieron más cuidados intensivos, mayor tiempo de internación y mayor tasa de letalidad (p < 0,01). La cardiopatía congénita fue predictor independiente de letalidad por VSR en prematuros [OR 3,67 (1,25-10,8), p = 0,01].Conclusión. VSR mostró un patrón epidémico, afectó a prematuros con ciertas comorbilidades con mayor morbimortalidad que los de término. La letalidad por VSR en prematuros se asoció con la cardiopatía congénita.

Introduction. Respiratory syncytial virus (RSV) is the leading cause of acute lower respiratory tract infection (ALRTI) in pediatrics. Preterm infants are at a higher risk for complications. We aimed to describe and compare the clinical and epidemiological characteristics associated with ALRTI due to RSV in preterm and term infants and to establish the predictors of fatality among preterm infants.Methods. Prospective, cross-sectional study of patients admitted due to ALRTI in the 2000-2018 period. Viral diagnosis was done by indirect immunofluorescence or reverse transcription polymerase chain reaction in nasopharyngeal aspirates. Clinical and epidemiological characteristics were recorded. A multiple logistic regression model established the predictors of fatality among preterm infants.Results. A total of 16 018 ALRTI cases were included; 13 545 (84.6 %) were tested; 6047 (45 %) were positive; RSV was prevalent in 81.1 % (4907), with a seasonal epidemic pattern; 14 % (686) were preterm infants.Comorbidities, perinatal respiratory history, congenital heart disease, malnutrition, chronic respiratory disease, bronchopulmonary dysplasia, prior hospitalization due to ALRTI, and chronic neurological disease (p < 0.001) were more common among preterm infants; they required more intensive care and a longer length of stay, and had a higher fatality rate (p < 0.01). Congenital heart disease was an independent predictor of fatality due to RSV among preterm infants (OR: 3.67 [1.25-10.8], p = 0.01).Conclusion. RSV showed an epidemic pattern and affected more preterm infants with certain comorbidities, with a higher morbidity and mortality, compared to term infants. RSV fatality among preterm infants was associated with congenital heart disease.

Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Virus Sincitiales Respiratorios , Infecciones del Sistema Respiratorio , Recien Nacido Prematuro , Estudios Epidemiológicos , Estudios Transversales , Estudios Prospectivos , Factores de Riesgo , Técnica del Anticuerpo Fluorescente Indirecta
Arch. argent. pediatr ; 118(6): 393-398, dic 2020. ilus
Artículo en Inglés, Español | LILACS, BINACIS | ID: biblio-1146056


Introducción. El uso excesivo de tecnología en niños pequeños es motivo de preocupación en la práctica pediátrica.Objetivo. Evaluar el uso de pantallas en niños < 4 años y su relación con la presencia de preocupación parental por el desarrollo psicomotor en áreas motora, del lenguaje, cognitiva y personal social. Población y métodos. Encuesta realizada a padres y/o madres de niños ≥ 18 meses y < 4 años, controlados en consultorio, durante febrero-mayo de 2018. Estudio descriptivo transversal.Resultados. Se realizaron 150 encuestas. Uso combinado de dispositivos en el 100 %: televisión, el 98 %; smartphones, el 80 %; tabletas, el 52,7 %; computadoras, el 24 %. Promedio de uso: 2,25 h/día en todas las edades (desvío estándar: 1,2). Uso y calidad: juegos, el 60 % (no didácticos, un 23 %); videos, el 88 % (no didácticos, un 20 %). Preocupación parental sobre el desarrollo: el 82 % no poseía; el 8,7 %, sobre el lenguaje; el 9,3 %, sobre falta de atención; las dos últimas coincidieron con mayor exposición: 2,92 h/día (p = 0,0024). Opinión parental sobre uso y efectos en el desarrollo: el 52 %, beneficioso; el 12 %, no influía; el 25,3 %, perjudicial, y el 10,7 %, perjudicial por uso excesivo; las dos últimas coincidieron con menor exposición: 1,8 horas/día (p = 0,0023).Conclusiones.El 100 % de los niños usa dispositivos en forma combinada. La preocupación parental por el desarrollo psicomotor se presenta cuando la exposición está fuera de las recomendaciones vigentes por edades.

Introduction. An excessive technology use among young children is a cause for concern in pediatric practice.Objective. To assess screen use among children < 4 years old and its relation to parental concern about psychomotor development regarding motor, language, cognitive, and personal-social skills.Population and methods. Survey administered to mothers and/or fathers of children aged ≥ 18 months and < 4 years seen at the outpatient office between February and May 2018. Descriptive, cross-sectional study.Results. A total of 150 surveys were completed. Combined device use in 100 %: TV, 98 %; smartphones, 80 %; tablets, 52.7 %; computers, 24 %. Average use: 2.25 h/day across all ages (standard deviation: 1.2). Use and quality: games, 60 % (non-educational, 23 %); videos, 88 % (non-educational, 20 %). Parental concern about development: 82 % had no concerns; 8.7 % was concerned about language; 9.3 %, about attention deficit; the latter two were consistent with a longerexposure time: 2.92 h/day (p = 0.0024). Parental opinion about use and effects on development:52 %, beneficial; 12 %, no effect; 25.3 %, harmful;and 10.7 %, harmful due to excessive use; the latter two were consistent with a shorter exposure time: 1.8 h/day (p = 0.0023).Conclusions. The 100 % of children use devices in combination. Parental concern about psychomotor development is expressed when exposure exceeds the current recommendations for age

Humanos , Masculino , Femenino , Lactante , Preescolar , Concienciación , Tiempo de Exposición , Dispositivos Móviles , Padres , Tecnología , Estudios Epidemiológicos , Estudios Transversales , Encuestas y Cuestionarios
Arch. argent. pediatr ; 118(6): 418-422, dic 2020. tab, ilus
Artículo en Inglés, Español | LILACS, BINACIS | ID: biblio-1146110


Introducción: Las alergias alimentarias afectan, mayoritariamente, a los niños en los primeros años de vida. Existen escasos datos epidemiológicos en nuestro país.Objetivos: Determinar los agentes causales, describir la prevalencia y características de los pacientes con alergia alimentaria en una población pediátrica argentina.Pacientes y métodos: Estudio retrospectivo observacional, de corte transversal, de pacientes menores de 18 años. Resultados: Se incluyeron 321 pacientes; se confirmó alergia alimentaria en un 64 % (207) de los casos. El 53 % (109) presentó mecanismo mediado por inmunoglobulina E; el 68 % (140), alergia a las proteínas de la leche de vaca; el 20 % (41), alergia al huevo, y el 12 % (24), anafilaxia como manifestación clínica. La prevalencia global de alergia alimentaria fue del 0,87 % (IC 95 %: 0,7-0,9).Conclusiones: La prevalencia global de alergia alimentaria fue del 0,87 %. La leche de vaca resultó el principal alérgeno incluso en adolescentes.

Introduction: Food allergies affect mostly children in their first years of life. Epidemiological data obtained in Argentina are scarce. Objectives: To determine offending foods and describe the prevalence and characteristics of patients with food allergy in an Argentine pediatric population. Patients and methods: Observational, retrospective, cross-sectional study on patients younger than 18 years. Results:A total of 321 patients were included; food allergy was confirmed in 64 % (207) of cases. An immunoglobulin E-mediated mechanism was observed in 53 % (109); cow's milk protein allergy, in 68 % (140); egg allergy, in 20 % (41); and anaphylaxis as clinical manifestation, in 12 % (24). The overall prevalence of food allergy was 0.87 % (95 % confidence interval: 0.7-0.9). Conclusions: The overall prevalence of food allergy was 0.87 %. Cow's milk was the main allergen, even among adolescents

Humanos , Masculino , Femenino , Niño , Adolescente , Hipersensibilidad a los Alimentos/diagnóstico , Inmunoglobulina E/inmunología , Estudios Epidemiológicos , Estudios Transversales , Estudios Retrospectivos , Hipersensibilidad a la Leche
Rev Soc Bras Med Trop ; 54: e00892020, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33338106


INTRODUCTION: Viral hepatitis is a major public health problem. It is necessary to understand the epidemic, verifying the combination of biological and demographic characteristics. METHODS: This is an analytical ecological and epidemiological study. Confirmed case data from the Notification Disease Information System (SINAN) were used. RESULTS: From 2009-2018, SINAN confirmed 404,003 viral hepatitis cases in Brazil, with 12.49%, 37.06%, and 48.28% cases of hepatitis A, B, and C, respectively. CONCLUSIONS: In Brazil, 4,296 deaths were associated with viral hepatitis, of which 36.66% were associated with acute hepatitis B. The proportional distribution of cases varied among the five Brazilian regions.

Hepatitis B , Hepatitis Viral Humana , Brasil/epidemiología , Estudios Epidemiológicos , Hepatitis B/epidemiología , Hepatitis Viral Humana/epidemiología , Humanos , Incidencia
BMJ Glob Health ; 5(12)2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33328201


Recent reports using conventional Susceptible, Exposed, Infected and Removed models suggest that the next wave of the COVID-19 pandemic in the UK could overwhelm health services, with fatalities exceeding the first wave. We used Bayesian model comparison to revisit these conclusions, allowing for heterogeneity of exposure, susceptibility and transmission. We used dynamic causal modelling to estimate the evidence for alternative models of daily cases and deaths from the USA, the UK, Brazil, Italy, France, Spain, Mexico, Belgium, Germany and Canada over the period 25 January 2020 to 15 June 2020. These data were used to estimate the proportions of people (i) not exposed to the virus, (ii) not susceptible to infection when exposed and (iii) not infectious when susceptible to infection. Bayesian model comparison furnished overwhelming evidence for heterogeneity of exposure, susceptibility and transmission. Furthermore, both lockdown and the build-up of population immunity contributed to viral transmission in all but one country. Small variations in heterogeneity were sufficient to explain large differences in mortality rates. The best model of UK data predicts a second surge of fatalities will be much less than the first peak. The size of the second wave depends sensitively on the loss of immunity and the efficacy of Find-Test-Trace-Isolate-Support programmes. In summary, accounting for heterogeneity of exposure, susceptibility and transmission suggests that the next wave of the SARS-CoV-2 pandemic will be much smaller than conventional models predict, with less economic and health disruption. This heterogeneity means that seroprevalence underestimates effective herd immunity and, crucially, the potential of public health programmes.

/epidemiología , Modelos Teóricos , Pandemias , Teorema de Bayes , Causalidad , Susceptibilidad a Enfermedades , Estudios Epidemiológicos , Humanos