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1.
Rev Clin Esp (Barc) ; 2024 Apr 18.
Artigo em Inglês | MEDLINE | ID: mdl-38642893

RESUMO

BACKGROUND: Acute hepatic porphyrias (AHPs) are a group of rare diseases that encompasses acute intermittent porphyria, variegate porphyria, hereditary coproporphyria, and 5-aminolaevulinic acid dehydratase deficiency porphyria. Symptoms of AHP are nonspecific which, together with its low prevalence, difficult the diagnosis and follow-up of these patients. MATERIAL AND METHODS: This project used DELPHI methodology to answer PICO questions related to management of patients with AHPs. The objective was to reach a consensus among multidisciplinary porhyria experts providing answers to those PICO questions for improving diagnosis and follow-up of patients with AHP. RESULTS: Ten PICO questions were defined and grouped in four domains: 1.- Biochemical diagnosis of patients with AHP, 2.- Molecular tests for patients with AHP, 3.- Follow-up of patients with AHP and 4.- Screening for long-term complications of patients with AHP. CONCLUSIONS: PICO questions and DELPHI methodology have provided a consensus on relevant and controversial issues for improving the management of patients with AHP.

2.
Braz J Anesthesiol ; : 844500, 2024 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-38554793

RESUMO

BACKGROUND: There is no consensus on the most effective strategy for Postoperative Pulmonary Complication (PPC) reduction. This study hypothesized that a Goal-Directed Fluid Therapy (GDFT) protocol of infusion of predetermined boluses reduces the occurrence of PPC in patients undergoing elective open abdominal surgeries when compared with Standard of Care (SOC) strategy. METHODS: Randomized, prospective, controlled study, conducted from May 2012 to December 2014, with ASA I, II or III patients undergoing open abdominal surgeries, lasting at least 120 min, under general anesthesia, randomized into the SOC and the GDFT group. In the SOC, fluid administration was according to the anesthesiologist's discretion. In the GDFT, the intervention protocol, based on bolus infusion according to blood pressure and delta pulse pressure, was applied. Patients were postoperatively evaluated by an anesthesiologist blinded to the group allocation regarding PPC incidence, mortality, and Length of Hospital Stay (LOHS). RESULTS: Forty-two patients in the SOC group and 43 in the GDFT group. Nineteen patients (45%) in the SOC and 6 in the GDFT (14%) had at least one PPC (p = 0.003). There was no difference in mortality or LOHS between the groups. Among the patients with PPC, four died (25%), compared to two deaths in patients without PPC (3%) (p = 0.001). The LOHS had a median of 14.5 days in the group with PPC and 9 days in the group without PPC (p = 0.001). CONCLUSION: The GDFT protocol resulted in a lower rate of PPC; however, the LOHS and mortality did not reduce.

3.
Rev. esp. anestesiol. reanim ; 71(3): 257-260, Mar. 2024. ilus
Artigo em Espanhol | IBECS | ID: ibc-230933

RESUMO

Un varón de 61 años sin predisposición trombótica es sometido a trasplante bipulmonar como último tratamiento para su EPOC terminal sin soporte de ECMO. Tras el implante y la reperfusión de ambos pulmones, se realizó un examen ecocardiográfico transesofágico completo para comprobar principalmente las anastomosis de las venas pulmonares. En este estudio se identificó una gran masa móvil, hiperecogénica, densa y heterogénea en la aurícula izquierda, compatible con un trombo en tránsito desde la circulación venosa pulmonar. Este hallazgo fue comunicado al equipo quirúrgico inmediatamente para reabrir la anastomosis y retirar el coágulo antes de mayores consecuencias. No hubo manifestaciones clínicas cuando se despertó al paciente.(AU)


61-year-old man without any thrombotic predisposition was undergone double sequential lung transplantation due to terminal stage of COPD without extracorporeal membrane oxygenation (ECMO) support. After implantation and reperfusion of both lungs, a complete transoesophageal echocardiography exam was performed to check especially the pulmonary venous anastomosis. In this exam, a large heterogenous, dense, hyperechoic mobile mass was identified in the LA, which was compatible with a thrombus in transit from pulmonary veins circulation. This finding was communicated to the surgical team to reopen the anastomosis and remove the clot before further consequences. There were no clinical manifestations when the patient was awakened.(AU)


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Ecocardiografia Transesofagiana , Veias Pulmonares/diagnóstico por imagem , Veias Pulmonares/lesões , Trombose , Doença Pulmonar Obstrutiva Crônica/tratamento farmacológico , Transplante de Pulmão , Anestesiologia , Pacientes Internados , Exame Físico , Transplantes
4.
Artigo em Inglês | MEDLINE | ID: mdl-38381397

RESUMO

BACKGROUND AND OBJECTIVE: The prevalence of food allergy (FA) has increased significantly, and the risk of developing anaphylaxis is unpredictable. Thus, discriminating between sensitized patients and those at risk of having a severe reaction is of utmost interest. To explore mast cell activation pattern and T follicular helper (TFH) 13 presence in sensitized and food anaphylaxis patients. METHODS: Patients sensitized to Lipid transfer protein (LTP) were classified as anaphylaxis or sensitized depending on the symptoms elicited by LTP-containing food. CD34+-derived MCs from patients and controls were obtained, sensitized with pooled sera, and challenged with Pru p 3 (peach LTP). Degranulation, PGD2, and cytokine/chemokine release were measured. The TFH13 population was examined by flow cytometry in the peripheral blood of all groups. In parallel, LAD2 cells were activated similarly to patients' MCs. RESULTS: A distinguishable pattern of mast cell activation was found in anaphylaxis compared to sensitized patients. Robust degranulation, PGD2, and IL-8 and GM-CSF secretion were higher in anaphylaxis, whereas TFG- and CCL2 secretion increased in sensitized patients. Concomitantly, anaphylaxis patients had a larger TFH13 population. MC activation profile was dependent on the sera rather than the MC source. In agreement with that, LAD2 cells reproduce the same pattern as MCs from anaphylactic and sensitized patients. CONCLUSION: The distinct profile of mast cell activation allows to discriminate between anaphylaxis and sensitized patients. Pooled sera may determine mast cell activation independently of mast cell origin. Besides, the presence of TFH13 cells in anaphylaxis patients points to an essential role of IgE affinity.

5.
Br J Haematol ; 204(2): 525-533, 2024 02.
Artigo em Inglês | MEDLINE | ID: mdl-37905734

RESUMO

Varnimcabtagene autoleucel (var-cel) is an academic anti-CD19 chimeric antigen receptor (CAR) product used for the treatment of non-Hodgkin lymphoma (NHL) in the CART19-BE-01 trial. Here we report updated outcomes of patients with NHL treated with var-cel. B-cell recovery was compared with patients with acute lymphoblastic leukaemia (ALL). Forty-five patients with NHL were treated. Cytokine release syndrome (any grade) occurred in 84% of patients (4% grade ≥3) and neurotoxicity in 7% (2% grade ≥3). The objective response rate was 73% at Day +100, and the 3-year duration of response was 56%. The 3-year progression-free and overall survival were 40% and 52% respectively. High lactate dehydrogenase was the only covariate with an impact on progression-free survival. The 3-year incidence of B-cell recovery was lower in patients with NHL compared to ALL (25% vs. 60%). In conclusion, in patients with NHL, the toxicity of var-cel was manageable, while B-cell recovery was significantly prolonged compared to ALL. This trial was registered as NCT03144583.


Assuntos
Linfoma de Células B , Linfoma não Hodgkin , Leucemia-Linfoma Linfoblástico de Células Precursoras , Receptores de Antígenos Quiméricos , Humanos , Sistemas Automatizados de Assistência Junto ao Leito , Linfoma de Células B/terapia , Linfoma não Hodgkin/terapia , Imunoterapia Adotiva/efeitos adversos , Anticorpos , Antígenos CD19 , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Linfócitos T
6.
Nurs Rep ; 13(4): 1706-1720, 2023 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-38133117

RESUMO

BACKGROUND: The end of life and death have changed from being issues managed within the family, assumed as part of life, to occur within health institutions for the majority of patients. The amount of patients dying at home has decreased, and the roles of families and communities in death and dying have become involuted, threatening related traditions and knowledge. As a result, a need to promote the end of life at home in this new self-serving society has arisen. In that context, the main objective of this study was to find out what patients and their families need during the end-of-life process in order to feel effectively accompanied at this time. METHODS: With that objective, a descriptive qualitative study was conducted via the content analysis of data from semi-structured interviews and focus groups. This research adhered to the COREQ guidelines. The sample consisted of 36 informants selected via intentional sampling of family members and patients integrated into the Comprehensive Palliative Care Process (PAI Paliativos). RESULTS: The results suggest the existence of several common needs such as communication and presence, including the conspiracy of silence as an important factor generating suffering for both. However, there are specific needs such as autonomy, dignity, and respect for patients, which must be taken into account. CONCLUSIONS: The results of this study will allow us to establish intervention strategies for effective accompaniment of patients' family members at the end of life and the avoidance of ethnocentrism in this process. This study was retrospectively registered with the (nursrep-1194226) on the (21 April 2023).

7.
Trop Anim Health Prod ; 55(5): 288, 2023 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-37578575

RESUMO

During the dry and rainy seasons of the Northeastern Zone of Peru, a chemical characterization of five species of bamboo prevalent in the area (Guadua lynnclarkiae, G. takahashiae, Bambusa vulgaris, G. weberbaueri, and Dendrocalamus asper) was conducted. Then, the effect of supplementing bamboo leaves (0, 20, and 40% inclusion of D. asper) on the intake and live weight gain of 18 Gyr × Holstein heifers was evaluated for 28 days. Among the species evaluated, D. asper has the greatest crude protein (CP) concentration (158-166 g/kg Dry matter- DM), post-ruminal CP supply (127 g/kg DM), and in vitro organic matter digestibility (444-456 g/kg DM) but similar concentrations of crude ash (124 g/kg DM), calcium (2.4-2.8 mg/g), phosphorus (0.7-2.1 mg/g), protein fractions A, B1, B2, B3, C (45, 5, 35, 56, and 17g/kg DM, respectively), rumen-undegraded CP (31% CP), neutral detergent fiber (NDF, 685g/kg DM), and acid detergent fiber (ADF, 357 g/kg DM) than the other species evaluated. Dry matter intake was higher in the control treatment and in the 20% bamboo leaf inclusion treatment than in the 40% bamboo inclusion treatment. Intake of CP and NDF decreased with the increase in bamboo inclusion. Despite the differences in DM, CP, and NDF intake, the live weight gain remained similar across treatments. However, there was a greater feed conversion in the 20% bamboo leaf inclusion treatment. During the dry season, bamboo leaves can be used as an alternative supplement at a maximum inclusion of 20% without affecting the live weight gain.


Assuntos
Fibras na Dieta , Digestão , Bovinos , Animais , Feminino , Peru , Fibras na Dieta/metabolismo , Ração Animal/análise , Detergentes/metabolismo , Aumento de Peso , Dieta/veterinária , Rúmen/metabolismo , Fermentação
8.
Front Psychiatry ; 14: 1132581, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37520236

RESUMO

Spirituality is defined as the meaning of life, being the very essence of life made up of all of the aspects inherent to it. During end-of-life processes, this need is shown to be particularly altered in patients and yet it is an aspect that the health professionals accompanying patients in this situation report being least equipped to address, alongside therapies that could help to meet these needs, such as art therapy. An exploratory qualitative study was conducted, adheres to the guidelines of COREQ (41). The study population were final year students undertaking a nursing degree at the University of Huelva, Spain. The sample was selected via intentional sampling using snowball recruitment from the study population. Stratification according to gender was performed due to the feminised nature of the population. Sample size was determined progressively during the research, with recruitment ceasing at 13 informants once information saturation was achieved. Inclusion criteria required that participants were to be final year students enrolled on a nursing degree who had provided consent to participate voluntarily in the research. The analysis Realized was interpretive phenomenological (IPA) as described by Smith (43-45). The present study revealed that students perceive their training on spiritual care to be deficient. Despite them reporting that they possess the skills and tools to provide end-of-life care, this is not enough to provide effective accompaniment, given that this moment brings them into touch with their own insecurities. Students verbalized the need to learn strategies to address this shortcoming regarding final accompaniment, for instance, through art, with creativity being one of the skills with the potential to uncover the meaning of life.

9.
Fisioterapia (Madr., Ed. impr.) ; 45(2): 113-120, mar.- abr. 2023. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-217339

RESUMO

Introducción Los fisioterapeutas necesitan amplios conocimientos anatómicos para valorar y tratar lesiones musculoesqueléticas. Las analogías entre las articulaciones humanas y porcinas son adecuadas para utilizar estas en la enseñanza de la anatomía humana. El objetivo es desarrollar una estrategia docente manipulativa, valorando su impacto en el aprendizaje anatómico y la satisfacción de los estudiantes. Materiales y métodos Cuarenta y cinco alumnos de 1.o de Fisioterapia realizan, dirigidos por un docente, la disección de piezas de cadera y rodilla de cerdo observando la morfología y características físicas tras la desarticulación, resección y secciones. Estudio observacional transversal que evalúa los resultados académicos después de la actividad, la satisfacción con la estrategia, la autopercepción de aprendizaje y el reconocimiento de las características físicas de las estructuras anatómicas. Resultados Los resultados tras la estrategia educativa son superiores a los obtenidos previamente (M=7,31; DE=2,31 vs. M=3,73; DE=2,29), siendo la diferencia estadísticamente significativa (t=−5,62; p=0,00; d de Cohen=0,50). Se determinan los valores descriptivos de cada ítem y las correlaciones entre los resultados académicos y la satisfacción (r=0,53; p=0,000), la autopercepción del conocimiento adquirido (r=0,33; p=0,028) y el reconocimiento de las características físicas (r=0,37; p=0,013). Conclusión La manipulación de estructuras animales permite conocer el elemento real sobre el que el fisioterapeuta va a ejercer su ejercicio profesional, mejorando los resultados académicos. Además, la estrategia resulta satisfactoria, por lo que puede recomendarse para el estudio de anatomía en el grado de Fisioterapia (AU)


Introduction Physiotherapists need extensive anatomical knowledge to assess and treat musculoskeletal injuries. The analogies between human and porcine joints are suitable for teaching human anatomy. The objective is to develop a manipulative teaching strategy assessing its impact on anatomical learning and satisfaction. Materials and method Forty-five physiotherapy 1st-year students perform, led by a teacher, the dissection of pig hip and knee pieces, observing the morphology and physical characteristics after disarticulation, resection and sections. A cross-sectional study that evaluates academic results after the activity, satisfaction with the strategy, the self-perception of learning, and the recognition of the physical characteristics of the anatomical structures. Results The results after the educational strategy are superior to those obtained previously (M=7.31; D.S=2.31 vs. M=3.73; D.S=2.29), the difference being statistically significant (t=-5.62; p=0.00; d of Cohen=0.50). The descriptive values of each item and the correlations between academic results and satisfaction (r=0.53; p=0.000), self-perception of acquired knowledge (r=0.33; p=0.028) and recognition of physical characteristics (r=0.37, p=0.013) are determined. Conclusion The manipulation of animal structures allows knowing the authentic element on which the physiotherapist will exercise his professional practice, improving academic results. In addition, the strategy is satisfactory so that it can be recommended for studying anatomy in the physiotherapy degree (AU)


Assuntos
Humanos , Animais , Especialidade de Fisioterapia/educação , Dissecação/educação , Modelos Animais , Modelos Anatômicos , Estudos Transversais
10.
Artigo em Inglês | MEDLINE | ID: mdl-36833896

RESUMO

BACKGROUND: Dementia stands out as a neurological disorder which constitutes a progressive decline in cognitive, behavioral, emotional, and social functioning. However, non-pharmacotherapy, such as music therapy, can be combined with pharmacological treatment as a possible strategy to improve functionality regarding the cognitive and non-cognitive dimensions of people diagnosed with dementia. OBJECTIVES: To analyze and synthesize published evidence regarding the effectiveness of music therapy in people diagnosed with dementia, concerning cognitive and non-cognitive outcomes. DESIGN: Descriptive study protocol of an umbrella review. METHODS AND ANALYSIS: An umbrella review method will guide this study, focusing on an extensive search of published systematic reviews and meta-analyses reviews that include randomized controlled trials and other types of trials. Databases for the article search include ISI Web of Knowledge, Scopus, and Joanna Briggs Institute (JBI) EBP database, and EBSCO Host platform (Cochrane Database of Systematic Reviews, MEDLINE, and CINAHL). Two reviewers will independently review all titles and abstracts and identify articles considering the inclusion criteria. Afterward, two reviewers will independently extract relevant information from each article for the characterization table, and evaluate the quality of selected articles using the Measurement Tool for Evaluating Systematic Reviews (AMSTAR) 2 guideline. RELEVANCE TO CLINICAL PRACTICE: Data from this study will aid in designing healthcare workers' training courses, clinical intervention guidelines, and specific intervention protocols that support pharmacological interventions in treating dementia.


Assuntos
Demência , Musicoterapia , Humanos , Revisões Sistemáticas como Assunto , Demência/terapia , Emoções , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto
13.
Nurs Rep ; 12(4): 775-790, 2022 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-36278769

RESUMO

The objective of this research was to learn about the effects of music as a non-pharmacological therapeutic intervention applied to Alzheimer's disease. To this aim, we evaluated its results regarding symptomatology and caregiver burden. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. We searched Pubmed/Medline (NLM), Web of Science, Scopus, Cochrane and Google Scholar, including articles from 1 January 2011-20 July 2021, using the keywords "Alzheimer´s disease", "Music therapy", "Caregivers overload", "Amnesia retrograde" and "Clinical evolution". To select the articles our criteria included complete text availability, quantitative research of an experimental nature and studies which, at least, figured in SJR or in JCR. Results: We found a relationship between the application of music therapy in patients with Alzheimer's disease and an improvement regarding symptomatology, as it smoothed down the progress of the disease. Using music therapy in Alzheimer's patients also led to a decrease in caregivers' burden and an increase in their well-being. Conclusions: Our results showed the benefits of music therapy, as it improved both patients' symptomatology and caregivers' burden.

15.
Artigo em Inglês | MEDLINE | ID: mdl-36011982

RESUMO

The current demographic panorama in Spain corresponds to an aging population; this situation is characterized by the need to care for an elderly population, which contains polymedicated and pluripathological individuals. Polymedication is a criterion of frailty in the elderly and a risk factor for mortality and morbidity due to the increased risk of drug interactions and medication errors. There are numerous studies that measure reconciliation at hospital discharge and at admission, and even the methodology of reconciliation, but we have not found many studies that measure reconciliation in the context of the COVID-19 pandemic from the point of view of health professionals regarding difficulties and the strategies carried out, which is essential to begin to glimpse solutions. METHODS: This was a qualitative study based on 21 in-depth interviews and two discussion groups, conducted between January and April 2021 (13 nurses and 8 doctors, in rural and urban areas). The discourse was analyzed according to the Taylor-Bodgan model and processed using Atlas.ti software. RESULTS: The areas altered by the health crisis were access to patients, their reconciliation of medication, and changes in the care modality, including the greater use of telephone communication, changes in work organization, and time dedicated to patient care and family work. Difficulties encountered during COVID-19: change in medication format, the specific characteristics of the patient and their pathologies, and difficulties arising from communication with the patient and their family. The strategies applied: the collaboration of home assistants and caregivers, emphasis on patient-health professional communication, and the use of Information and Communication Technologies (ICT). CONCLUSION: The discharge was interrupted by the health crisis caused by COVID-19, in terms of both the traditional access of patients and by the remote care modalities generated by telemedicine.


Assuntos
COVID-19 , Telemedicina , Idoso , COVID-19/epidemiologia , Idoso Fragilizado , Hospitais , Humanos , Reconciliação de Medicamentos/métodos , Pandemias , Alta do Paciente , Percepção
16.
Foods ; 11(16)2022 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-36010433

RESUMO

The goal of this exploratory study was to analyze the influence of culture on African women's diet considering their role as primary caregivers. The analysis differentiated between Moroccan and Senegalese women and identified the key elements that influence their dietary habits and their health. Using a qualitative methodology, we performed a triangulation of data based on a literature review and a panel of experts, all of which served as the basis for the interview script to conduct 14 semi-structured interviews (n = 7 Moroccan and n = 7 Senegalese). This study reflects the substantial relationship between dietary habits, cultural identity, and health that healthcare providers need to acknowledge. It is important for healthcare practitioners to be culturally competent in order to provide holistic and individualized care.

17.
Med. intensiva (Madr., Ed. impr.) ; 46(7): 372-382, jul. 2022. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-207848

RESUMO

Objetivo Describir las prácticas relacionadas a ventilación mecánica (VM) en Argentina y explorar los factores asociados a la mortalidad en UCI en esta población. Diseño Se realizó un estudio observacional, prospectivo, multicéntrico. Ámbito Unidad de Cuidados Intensivos. Pacientes Incluimos pacientes mayores de 18 años ingresados en las UCI participantes que requirieron VM invasiva durante al menos 12 horas desde el ingreso a la institución de salud. Intervenciones Ninguna. Variables Todas las variables se clasificaron en tres categorías: variables relacionadas con factores demográficos y clínicos antes de la VM, factores relacionados con el primer día de VM, y factores relacionados con los eventos ocurridos durante la VM (complicaciones y destete de la VM). El destete de la ventilación mecánica y la mortalidad se clasificaron según WIND (Weaning according to a New Definition). Resultados El análisis primario incluyó a 950 pacientes. La principal indicación de VM fue insuficiencia respiratoria aguda (58% de los pacientes). El modo de ventilación inicial fue ventilación mandatoria continua con control de volumen en el 75% de los casos. La mortalidad en UCI y hospitalaria fue del 44,6% y 47,9%, respectivamente. Las variables identificadas como predictoras independientes de mortalidad en UCI fueron edad (OR 3,48 IC 95%, 1,22-11,66; p=0,028), fracaso en la implementación de ventilación mecánica no invasiva (VNI) antes de VM (OR 2,76, IC 95%, 1,02-7,10; p=0,038), diagnóstico de sepsis (OR 2,46, IC 95%, 1,09-5,47; p=0,027) y fracaso de la extubación (OR 4,50, IC 95%, 2,05-9,90; p<0,001). Conclusiones El presente estudio permitió describir las características y evolución clínica de los pacientes que recibieron ventilación mecánica en Argentina, encontrando como principal resultado que la mortalidad fue mayor a la reportada en estudios internacionales (AU)


Objetive To describe mechanical ventilation (MV) practices in Argentina, and to explore factors associated with ICU mortality in this population. Design A prospective, multicenter, observational study was carried out. Setting Intensive Care. Patients We enrolled patients above 18 years old admitted to any of the participating ICUs requiring invasive MV for at least 12hours since the admission to the healthcare institution, including MV initiation in emergency department, operating room or other hospitals. Interventions None. Variables All variables were classified into three categories: variables related to demographic and clinical factors before the MV, factors related to the first day on MV, and factors related to events happening during the MV (complications and weaning from MV). Mechanical ventilation weaning and mortality were classified according to WIND. Results The primary analysis included 950 patients. The main indication for MV was acute respiratory failure (58% of patients). Initial ventilation mode was volume control-continuous mandatory ventilation in 75% of cases. ICU and hospital mortality were 44.6% and 47.9% respectively. The variables identified as independent predictors of mortality in ICU were age (OR3.48 IC95% 1.22-11.66; p=0.028), failure to implement NIV before MV (OR 2.76, IC 95%, 1.02-7.10; p=0.038), diagnosis of sepsis (OR 2.46, IC 95%, 1.09-5.47; p=0.027) and extubation failure (OR 4.50, IC 95%, 2.05-9.90; p<0.001). Conclusions The present study allowed us to describe the characteristics and clinical course of the patients who received mechanical ventilation in Argentina, finding as the main result that mortality was higher than that reported in international studies (AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Unidades de Terapia Intensiva/estatística & dados numéricos , Respiração Artificial/estatística & dados numéricos , Desmame do Respirador , Mortalidade Hospitalar , Estudos Prospectivos , Argentina/epidemiologia
18.
Med Intensiva (Engl Ed) ; 46(7): 372-382, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35660286

RESUMO

OBJETIVE: To describe mechanical ventilation (MV) practices in Argentina, and to explore factors associated with ICU mortality in this population. DESIGN: A prospective, multicenter, observational study was carried out. SETTING: Intensive Care. PATIENTS: We enrolled patients above 18 years old admitted to any of the participating ICUs requiring invasive MV for at least 12 h since the admission to the healthcare institution, including MV initiation in emergency department, operating room or other hospitals. INTERVENTIONS: None. VARIABLES: All variables were classified into three categories: variables related to demographic and clinical factors before the MV, factors related to the first day on MV, and factors related to events happening during the MV (complications and weaning from MV). Mechanical ventilation weaning and mortality were classified according to WIND. RESULTS: The primary analysis included 950 patients. The main indication for MV was acute respiratory failure (58% of patients). Initial ventilation mode was volume control-continuous mandatory ventilation in 75% of cases. ICU and hospital mortality were 44.6% and 47.9% respectively. The variables identified as independent predictors of mortality in ICU were age (OR 3.48 IC 95% 1.22-11.66; p = 0.028), failure to implement NIV before MV (OR 2.76 IC 95% 1.02-7.10; p = 0.038), diagnosis of sepsis (OR 2.46 IC 95% 1.09-5.47; p = 0.027) and extubation failure (OR 4.50 IC 95% 2.05-9.90; p < 0.001). CONCLUSIONS: The present study allowed us to describe the characteristics and clinical course of the patients who received mechanical ventilation in Argentina, finding as the main result that mortality was higher than that reported in international studies.


Assuntos
Respiração Artificial , Desmame do Respirador , Adolescente , Argentina/epidemiologia , Humanos , Unidades de Terapia Intensiva , Estudos Prospectivos
19.
Foods ; 11(12)2022 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-35741913

RESUMO

The university stage is a crucial stage that influences the decision-making process of students. At this stage, they acquire dietary habits that are guided by their likes, beauty ideals, biological influences, and economic factors. During the COVID-19 pandemic, universities closed and turned to online teaching, changing their life habits under the duress of confinement. The aim of the present work was to identify the dietary behaviours of nursing and engineering degree students at the University of Huelva during the period of confinement, in addition to identifying the factors influencing these habits. The methodological strategy employed was mixed in nature. In this sense, a cross-sectional descriptive study was first performed, followed by a phenomenological qualitative study that was descriptive in nature. Examination of outcomes revealed the presence of four lines of argument founded on the influence of context, life habits, emotional changes experienced during the COVID-19 pandemic, and the factors facilitating or limiting adaption to this period. Taking into account that confinement, restrictive measures, the absence of family, closeness and affection, and training influenced changes to feeding habits and approaches to consumption, universities could carry out interventions oriented in this line to favour healthy eating habits.

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