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1.
Goiânia; SES-GO; 01 março 2021. 1-50 p. ilus, tab.
Não convencional em Português | LILACS, Coleciona SUS, CONASS, SES-GO | ID: biblio-1096093

RESUMO

O surto da doença respiratória causada pelo novo coronavírus (SARS-CoV-2) aconteceu na cidade de Wuhan, capital da província de Hubei, na China, em dezembro de 2019, a qual disseminou-se de forma acelerada e, logo, atingiu mais de uma centena de países dos cinco continentes. Em 12 de março de 2020, a situação foi caracterizada como pandemia pela Organização Mundial de Saúde (OMS, 2020). Em razão da disseminação o do Coronavírus pelo mundo, o Ministério da Saúde declarou Emergência de Saúde Pública de Importância Nacional (ESPIN) em decorrência da infecção pelo novo coronavírus (COVID-19) e estabeleceu o Centro de Operações de Emergência em Saúde Pública (COE-COVID-19) como mecanismo de gestão coordenada da resposta à ESPIN no país (BRASIL, 2020a). Seguindo a linha mundial, o Ministério da Saúde elaborou e publicou "Plano de Contingência Nacional para Infecção Humana pelo Novo Coronavírus COVID-19" para organizar a detecção, monitoramento e resposta dos serviços de saúde à doença (BRASIL, 2020b). O Estado de Goiás instituiu o Centro de Operações Estratégicas de Saúde Pública (COE) em 18 de fevereiro de 2020 (GOIÁS, 2020a). E, seguindo as orientações nacionais, propõe o presente PLANO ESTADUAL DE CONTINGÊNCIA PARA O ENFRENTAMENTO DA DOENÇA PELO CORONAVÍRUS (COVID-19), a fim de organizar e fortalecer as políticas públicas de saúde, visto que, para que atinjam eficácia e eficiência, é necessário atuação conjunta e ordenada dos entes federados, bem como dos setores públicos e privados.


The outbreak of respiratory disease caused by the new coronavirus (SARS-CoV-2) occurred in Wuhan city, capital of Hubei province, China, in December 2019, which spread rapidly and thus reached more than a hundred countries on five continents. On March 12, 2020, the situation was characterized as a pandemic by the World Health Organization (WHO, 2020). Due to the spread of Coronavirus around the world, the Ministry of Health declared a Public Health Emergency of National Importance (ESPIN) due to infection by the new coronavirus (COVID-19) and established the Center for Emergency Operations in Public Health (COE-COVID-19) as a mechanism for coordinated management of the response to ESPIN in the country (BRASIL, 2020a). Following the global line, the Ministry of Health elaborated and published "National Contingency Plan for Human Infection by the New Coronavirus COVID-19" to organize the detection, monitoring and response of health services to the disease (BRASIL, 2020b). The State of Goiás established the Center for Strategic Operations of Public Health (COE) on February 18, 2020 (GOIÁS, 2020a). And, following the national guidelines, it proposes this State CONTINGENCY PLAN FOR COPING WITH CORONAVIRUS DISEASE (COVID-19), in order to organize and strengthen public health policies, since, in order to achieve effectiveness and efficiency, joint and orderly action of federal entities, as well as public and private sectors, is necessary.


Assuntos
Humanos , Masculino , Feminino , Gravidez , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Saúde Pública , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Infecções por Coronavirus/transmissão , Pandemias
2.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48052

RESUMO

Documento que detalha tratamento, diagnóstico e monitoramento de pacientes passam por atualizações constantes, a fim de garantir manejo baseado nas evidências científicas mais modernas


Assuntos
Esclerose Múltipla/diagnóstico , Esclerose Múltipla/tratamento farmacológico , Protocolos Clínicos
3.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48043

RESUMO

Ações para o enfrentamento das doenças estão voltadas para o autoconhecimento do corpo no diagnóstico e tratamento precoce


Assuntos
Neoplasias/prevenção & controle , Neoplasias/diagnóstico
4.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48045

RESUMO

O Ministério da Saúde emitiu nesta terça-feira (2) Nota Técnica para os Estados e Distrito Federal sobre a nova variante do SARS-CoV-2 identificada no Brasil. O documento traz informações sobre as características da nova variante do Amazonas (VOC P.1) e orientações e recomendações de medidas que devem ser adotadas e intensificadas pelas secretarias de saúde estaduais, a fim de monitorar e evitar a propagação da nova variante.


Assuntos
Betacoronavirus , Síndrome Respiratória Aguda Grave/prevenção & controle , Síndrome Respiratória Aguda Grave/diagnóstico
5.
Recurso na Internet em Inglês, Espanhol, Português | LIS - Localizador de Informação em Saúde | ID: lis-48046

RESUMO

À véspera do Dia Mundial De Combate ao Câncer, comemorado no dia 4 de fevereiro, a diretora da Organização Pan-Americana da Saúde (OPAS), Carissa F. Etienne, pediu para que o diagnóstico e o tratamento desta doença sejam garantidos nos países das Américas, onde os serviços foram seriamente interrompidos durante a pandemia de COVID-19.


Assuntos
América , Neoplasias/diagnóstico , Neoplasias/tratamento farmacológico , Organização Pan-Americana da Saúde
6.
Goiânia; S.n; Fev. 05,2021. 22 p. ilus, tab, graf, mapas.(Boletim Epidemiológico Covid-19, 44).
Monografia em Português | Coleciona SUS, CONASS, SES-GO | ID: biblio-1147539

RESUMO

A Secretaria de Estado da Saúde de Goiás através da Superintendência de Vigilância em Saúde e Gerência de Vigilância Epidemiológica através deste Boletim informa que, Desde os primeiros registros de casos suspeitos de COVID-19 em Goiás em 04 de fevereiro de 2020 até 30 de janeiro de 2021 foram notificados à Vigilância Epidemiológica 1.008.969 casos. Nesta última semana epidemiológica analisada (SE 04/2021) houve a confirmação de 12.831 casos novos, representando um aumento de 40%, quando comparado ao número de casos confirmados na SE 03. Na última semana avaliada (SE 04/2021), 104 (42,3%) dos municípios goianos confirmaram novos casos de COVID-19. Goiânia, registrou o maior número, 85 casos, seguido por Catalão com 50, Morrinhos com 45 e Caldas Novas com 23. Do total de casos confirmados de COVID-19 até dia 30 de janeiro de 2021,10.819 (3,1%) eram trabalhadores da saúde. Ocorreu um aumento de 1,8% no registro de profissionais da saúde com relação a SE anterior. Na SE 04/2021 foi registrado 1 óbito de profissional de saúde. Na SE 04 foram registrados 295 novos casos que necessitaram de cuidados intensivos, um aumento de 0,6% em relação a SE 03 (293)


The State Department of Health of Goiás through the Superintendence of Health Surveillance and Management of Epidemiological Surveillance through this Bulletin informs that, Since the first records of suspected cases of COVID-19 in Goiás on February 4, 2020 to January 30, 2021 were notified to epidemiological surveillance 1,008,969 cases. In this last epidemiological week analyzed (SE 04/2021) there was confirmation of 12,831 new cases, representing an increase of 40%, when compared to the number of confirmed cases in SE 03. In the last week evaluated (SE 04/2021), 104 (42.3%) municipalities confirmed new cases of COVID-19. Goiânia, recorded the highest number, 85 cases, followed by Catalan with 50, Morrinhos with 45 and Caldas Novas with 23. Of the total number of confirmed cases of COVID-19 by January 30, 2021, 10.819 (3,1%) were health workers. There was a 1.8% increase in the registration of health professionals in relation to the previous SE. In SE 04/2021, 1 death of a health professional was recorded. In SE 04, 295 new cases requiring intensive care were recorded, an increase of 0.6% compared to SE 03 (293)


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/epidemiologia , Pandemias , Betacoronavirus , Brasil/epidemiologia , Incidência , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade
7.
Goiânia; S.n; Fev. 12, 2021. 23 p. ilus, tab, graf, mapas.(Boletim Epidemiológico Covid-19, 45).
Monografia em Português | Coleciona SUS, CONASS, SES-GO | ID: biblio-1147990

RESUMO

Secretaria de Estado da Saúde de Goiás através da Superintendência de Vigilância em Saúde e Gerência de Vigilância Epidemiológica apresenta as informações através deste Boletim, que desde os primeiros registros de casos suspeitos de COVID-19 em Goiás em 04 de fevereiro de 2020 até 06 de fevereiro de 2021 foram notificados à Vigilância Epidemiológica 1.037.296 casos. Desta data até 06 de fevereiro de 2021 foram confirmados 360.742 (34,8%) sendo 335.899 (93,1%) por critério laboratorial, 12.512 (3,5%) pelo critério clínico epidemiológico, 2.181 (0,6%) por critério clínico-imagem e 9.355 (2,6%) pelo critério clínico. Do total de notificados, 367.339 (35,4%) foram descartados e 309.215 (29,8%) continuam como suspeitos. Na última semana avaliada (SE 05/2021), 97 (39,4%) dos municípios goianos confirmaram novos casos de COVID-19. Goiânia registrou 200 casos, seguida por Inhumas com 46, Morrinhos com 31 e Rubiataba com 28. Na SE 05/2021 foram registrados 211 novos óbitos por COVID-19 distribuídos por 73 municípios (29,7% do total do estado). Um aumento de 2,9% em relação ao total de registros da SE anterior (205). Cento e noventa e quatro óbitos continuam em investigação. Na SE 05/2021 não foi registrado óbito de profissional de saúde. Na SE 05/2021 foram notificados 793 novos casos de SRAG por COVID-19, 3,7% a mais do que na SE 04 (765)


The State Department of Health of Goiás through the Superintendence of Health Surveillance and Management of Epidemiological Surveillance presents the information through this Bulletin, which from the first records of suspected cases of COVID-19 in Goiás on February 4, 2020 to February 6, 2021 were notified to epidemiological surveillance 1,037,296 cases. From this date until February 6, 2021 360,742 (34.8%) 335,899 (93.1%) by laboratory criterion, 12,512 (3.5%) by epidemiological clinical criterion, 2,181 (0.6%) by clinical-imaging criterion and 9,355 (2.6%) by clinical criterion. Of the total number of notified, 367,339 (35.4%) were discarded and 309,215 (29.8%) remain as suspects. In the last week evaluated (SE 05/2021), 97 (39.4%) municipalities confirmed new cases of COVID-19. Goiânia recorded 200 cases, followed by Inhumas with 46, Morrinhos with 31 and Rubiataba with 28. In SE 05/2021, 211 new deaths due to COVID-19 were recorded distributed in 73 municipalities (29.7% of the total state). An increase of 2.9% in relation to the total number of previous SE records (205). One hundred and ninety-four deaths are still under investigation. In SE 05/2021, no death of a health professional was recorded. In SE 05/2021, 793 new cases of SRAG were reported by COVID-19, 3.7% more than in SE 04 (765)


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/epidemiologia , Pandemias , Betacoronavirus , Brasil/epidemiologia , Incidência , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Monitoramento Epidemiológico
8.
BMC Surg ; 21(1): 99, 2021 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-33622302

RESUMO

BACKGROUND: It is important to understand the branching pattern of the celiac artery for a safe surgery. Various branching anomalies of the celiac artery were classified by Adachi in 1928. In Adachi's classification, type VI (group 26) is a rare anatomical anomaly (0.4%) that requires care when carrying out a surgery in gastric cancer patients with this anomaly. Herein, we reported a case treated successfully with laparoscopic distal gastrectomy with D1+ lymph node dissection for early gastric cancer. CASE PRESENTATION: An 84-year-old female was referred to our division for an additional surgical treatment for early gastric cancer that was resected by endoscopic submucosal dissection. A three-dimensional computed tomography angiography revealed an angioplany of the common hepatic artery branching from the left gastric artery. According to Adachi's classification, the anomaly of this patient corresponded to type VI (group 26). Preoperative anatomical information of this rare anomaly helped us to safely perform a laparoscopic distal gastrectomy and lymph node dissection with common hepatic artery preservation. The patient had an uneventful postoperative course and was discharged on postoperative day 11. CONCLUSIONS: We consider that Group 26 anomalies require the most precise anatomical understanding among Adachi classification type VIs, since it affects hepatic blood flow and can cause serious complications. In this time, we reported a successful case to perform laparoscopic distal gastrectomy with safety and accuracy by preoperative understanding of the precise vascular anatomy.


Assuntos
Neoplasias Gástricas , Idoso de 80 Anos ou mais , Feminino , Humanos , Laparoscopia , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/cirurgia
9.
BMC Surg ; 21(1): 100, 2021 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-33622311

RESUMO

BACKGROUND: Epidermolysis bullosa is a group of rare inherited skin diseases characterized by blister formation following mechanical skin trauma. Epidermolysis bullosa is associated with increased skin cancer rates, predominantly squamous cell carcinomas, yet to our best knowledge, there is no reported case of dermatofibrosarcoma protuberans in a patient with Epidermolysis bullosa. CASE PRESENTATION: Here, we present a 26-year-old man with junctional epidermolysis bullosa, who developed a DFSP on the neck. Initial, the skin alteration was mistakenly not considered malignant, which resulted in inadequate safety margins. The complete resection required a local flap to close the defect, which is not unproblematic because of the chronic inflammation and impaired healing potential of the skin due to Epidermolysis bullosa. CONCLUSIONS: To our best knowledge, this is the first reported case of a skin-associated sarcoma in a patient with EB; however, further investigation is required to verify a correlation.


Assuntos
Dermatofibrossarcoma , Epidermólise Bolhosa Juncional , Neoplasias Cutâneas , Adulto , Dermatofibrossarcoma/diagnóstico , Dermatofibrossarcoma/cirurgia , Epidermólise Bolhosa Juncional/epidemiologia , Humanos , Masculino , Neoplasias Cutâneas/diagnóstico , Neoplasias Cutâneas/cirurgia
11.
Acta Gastroenterol Belg ; 84(1): 9-17, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33639688

RESUMO

Background and study aims: Atrophic gastritis (AG) and intestinal metaplasia (IM) are established premalignant gastric lesions. Many studies documented a poor correlation between esophagogastroduodenoscopy (EGD) and histopathological (HP) findings of precancerous gastric lesions. The aim was to bridge the gap between endoscopy and HP in detection of chronic gastritis, AG and IM. Patients and methods: a prospective single-center study involved 150 patients with endoscopic criteria of gastric lesions with upper gastrointestinal symptoms referred for upper GI endoscopy met the endoscopic criteria and classified according to HP of biopsies from targeted gastric lesions into chronic gastritis (GI), AG(GII) or IM(GIII). We correlated the endoscopic criteria of the 3 groups with the HP results. Results: (73 males & 75 females) with ages ranged17-75 years and mean± SD was 41.96 ± 15.95. GI, GII & GIII were [42 patients (28%),82 patients (54.7%) and 26 patients (17.3%)], respectively. Diffuse gastric mottling was more common in GI (74.3%, P<0.001), visible submucosal vessels, gastric atrophy predominated in GII (75.6, 82.3 & 73.1% (P 0.005,0.4 & <0.01)), respectively. Whitish raised lesions were more specific in GIII (85.7%) (P<0.001). The sensitivity and specificity of endoscopic suspicion of chronic gastritis were (86&88% in GI), (87&85% in GII) and (54% & 100% in GIII) (p-0.001). The logistic regression model for risk factors was χ2= 25.74 and 49.32, p < 0.001. Conclusion: Conventional endoscopy has high sensitivity and specificity for suspicion of chronic gastritis and AG, but low sensitivity and very high specificity for IM. Targeted biopsies may be valuable with image enhanced techniques.


Assuntos
Gastrite Atrófica , Infecções por Helicobacter , Helicobacter pylori , Lesões Pré-Cancerosas , Neoplasias Gástricas , Adolescente , Adulto , Idoso , Biópsia , Feminino , Mucosa Gástrica , Gastrite Atrófica/diagnóstico , Gastroscopia , Humanos , Masculino , Metaplasia , Pessoa de Meia-Idade , Estudos Prospectivos , Adulto Jovem
12.
Acta Gastroenterol Belg ; 84(1): 19-24, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33639689

RESUMO

Background: Impact of antithrombotics on the fecal immunochemical test (FIT) for colorectal cancer (CRC) screening remains unclear. Methods: Patients undergoing colonoscopy for positive FIT in 2015 were assessed at 3 Belgian centers. Significant findings were advanced polyps (AP) (sessile serrated, tubular or villous adenomas >1cm or high-grade dysplasia) and CRC. False positive FIT and detection of AP/CRC with antithrombotics were calculated. Results: 510 patients (64% male, median (IQR) age 63.2 (60.2 - 66.4) years) were included. Colorectal pathology in 371/510 (73%) was associated with male gender (70% vs. 48% ; p= .0001) and family history (16% vs. 8% ; p= .02). Antithrombotics in 125/510 (25%) were associated with male gender (78% vs. 59% ; p= .0001), older age (65.2 (62.2-70.3) vs. 62.3 (58.7-66.3) years ; p= .0001) and GI-symptoms (18% vs. 11% ; p= .04). False positive FIT (25% vs. 28% ; p= .52) and detection of AP (42% vs. 36% ; p=.27) or CRC (6% vs. 5% ; p= .69) were similar in patients with vs. no antithrombotics. Use of antithrombotics did not predict a higher chance of colorectal pathology after adjusting for confounders. Conclusion: Although antithrombotics were prescribed more frequently in male and older patients, detection of AP/CRC was similar. Despite increased GI symptoms, false positive FIT was similar with antithrombotics.


Assuntos
Neoplasias Colorretais , Fibrinolíticos , Idoso , Bélgica/epidemiologia , Colonoscopia , Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/tratamento farmacológico , Detecção Precoce de Câncer , Fezes , Feminino , Humanos , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade
13.
Acta Gastroenterol Belg ; 84(1): 95-99, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33639700

RESUMO

Liver disease, cirrhosis and portal hypertension can be complicated by pulmonary vascular disease, which may affect prognosis and influence liver transplantation (LT) candidacy. Pulmonary vascular complications comprise hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH). Although these two conditions develop on a same background and share a common trigger, pulmonary responses are distinct and occur at different anatomical sites of the pulmonary circulation. HPS affects 10-30% of patients referred for LT, and is characterized by gas exchange abnormalities due to pulmonary vasodilation and right-to-left shunting. POPH occurs in 5%, and is defined by pulmonary arterial hypertension due to increased pulmonary vascular resistance, which leads to hemodynamic failure. Even though HPS and POPH may have a substantial negative impact on survival, both entities are clinically underrecognized and frequently misdiagnosed. Without intervention, the 5-year survival rate is 23% in HPS and 14% in POPH. Their presence should be actively sought by organized screening in patients presenting with dyspnea and in all patients on the waitlist for LT, also because clinical symptoms are commonly non-specific or even absent. LT may lead to resolution, however, advanced stages of either HPS or POPH may jeopardize safe and successful LT. This implicates the need of proper identification of HPS and POPH cases, as well as the need to be able to successfully 'bridge' patients to LT by medical intervention. A review article on this topic has been published in this journal in 2007 (1). This updated review focuses on recent advances in the diagnosis and management of these 2 liver-induced pulmonary vascular disorders and incorporates results from our recent work.


Assuntos
Síndrome Hepatopulmonar , Hipertensão Portal , Hipertensão Pulmonar , Hipertensão Arterial Pulmonar , Síndrome Hepatopulmonar/diagnóstico , Síndrome Hepatopulmonar/terapia , Humanos , Hipertensão Portal/complicações , Hipertensão Portal/diagnóstico , Hipertensão Portal/terapia , Hipertensão Pulmonar/diagnóstico , Hipertensão Pulmonar/etiologia , Hipertensão Pulmonar/terapia , Cirrose Hepática
14.
Acta Gastroenterol Belg ; 84(1): 101-120, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33639701

RESUMO

Introduction: Hemorrhoidal disease is a common problem that arises when hemorrhoidal structures become engorged and/or prolapse through the anal canal. Both conservative and invasive treatment options are diverse and guidance to their implementation is lacking. Methods: A Delphi consensus process was used to review current literature and draft relevant statements. These were reconciliated until sufficient agreement was reached. The grade of evidence was determined. These guidelines were based on the published literature up to June 2020. Results: Hemorrhoids are normal structures within the anorectal region. When they become engorged or slide down the anal canal, symptoms can arise. Every treatment for symptomatic hemorrhoids should be tailored to patient profile and expectations. For low-grade hemorrhoids, conservative treatment should consist of fiber supplements and can include a short course of venotropics. Instrumental treatment can be added case by case : infrared coagulation or rubber band ligation when prolapse is more prominent. For prolapsing hemorrhoids, surgery can be indicated for refractory cases. Conventional hemorrhoidectomy is the most efficacious intervention for all grades of hemorrhoids and is the only choice for non-reducible prolapsing hemorrhoids. Conclusions: The current guidelines for the management of hemorrhoidal disease include recommendations for the clinical evaluation of hemorrhoidal disorders, and their conservative, instrumental and surgical management.


Assuntos
Hemorroidectomia , Hemorroidas , Bélgica , Hemorroidas/diagnóstico , Hemorroidas/terapia , Humanos , Ligadura , Resultado do Tratamento
15.
Acta Gastroenterol Belg ; 84(1): 121-124, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33639702

RESUMO

Cobalamin or vitamin B12 (vitB12) is involved in DNA synthesis, haematopoiesis and myelinisation. Consequently, vitB12 deficiency causes various symptoms, such as megaloblastic anaemia, neurologic signs or pancytopenia. Despite possible severe symptoms, vitB12 deficiency can present asymptomatically. We report six paediatric patients with different aetiologies of vitB12 deficiency ranging from a subtle to a more overt presentation. VitB12 deficiency is a diagnostic challenge due to the lack of consensus on normal values of vitB12 and its co-markers (folate, holotranscobalamin, methylmalonic acid, homocysteine) and the lack in specificity and sensitivity of the serum vitB12 analysis. All cases were treated with parenteral vitB12. Last decades, evidence supporting high dose oral treatment being as effective as the intramuscular (IM) therapy, also in children, is growing.


Assuntos
Deficiência de Vitamina B 12 , Biomarcadores , Criança , Testes Diagnósticos de Rotina , Ácido Fólico , Humanos , Vitamina B 12 , Deficiência de Vitamina B 12/diagnóstico , Deficiência de Vitamina B 12/tratamento farmacológico
18.
Adv Clin Exp Med ; 30(1): 35-40, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33529505

RESUMO

BACKGROUND: Type 2 diabetes (T2D) is known to be one of the most prevalent diseases, and its prevalence is significantly associated with age and metabolic syndrome (MetS). Few studies have been conducted on liver function, MetS and insulin secretion among young adults. OBJECTIVES: In the present study, we explored the relationship between the liver function enzyme - alanine aminotransferase (ALT) - and first-phase insulin secretion (FPIS) among young adults. MATERIAL AND METHODS: There were 22,971 men and 28,740 women, aged 18-27 years, assigned to subgroups according to the presence of MetS and quartiles of ALT values. Simple correlation was applied to evaluate their relationship. The difference between the slopes of these relationships and FPIS were statistically analyzed with Chris's calculator. RESULTS: Most values for metabolic parameters, including ALT and FPIS, were determined to be relatively high in individuals with MetS. By contrast, individuals with MetS had lower high-density-lipoprotein cholesterol (HDL-C) counts and FPIS. Similar results were observed in the quartiles of ALT. Significant positive results were also found in the linear model. Depending on the ALT level, the slope change of FPIS still demonstrated a positive correlation between ALT and FPIS. This correlation was stronger for men than for women. CONCLUSIONS: A positive correlation between ALT and FPIS exists among young adults. Moreover, this correlation was stronger for men than for women. Both the cause and the effect require further investigation.


Assuntos
Resistência à Insulina , Secreção de Insulina , Síndrome Metabólica , Adolescente , Adulto , Alanina Transaminase , HDL-Colesterol , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Adulto Jovem
19.
Adv Clin Exp Med ; 30(1): 67-75, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33529509

RESUMO

BACKGROUND: Despite the progress in the treatment of heart failure with reduced ejection fraction (HFrEF), the prognosis remains unfavorable. OBJECTIVES: To evaluate the effectiveness, tolerance and safety after one-year follow-up of Polish patients with stable chronic HFrEF treated with sacubitril/valsartan. MATERIAL AND METHODS: This was an observational multicenter study conducted in 3 centers (Kraków, Lódz and Warszawa) specializing in heart failure (HF). We enrolled 89 HFrEF patients (aged 59.3 ±13.5 years, 82% males) in NYHA class II-IV (ambulatory). Clinical, laboratory and echocardiographic parameters were evaluated at baseline and after a one-year follow-up. The composite endpoint was defined as death or urgent HF hospitalization. RESULTS: After 1 year, 80% of patients used 50% or more of the target dose of sacubitril/valsartan. After a year of treatment, there were significant improvements of HF symptoms, N-terminal prohormone B-type natriuretic peptide (NT proBNP), ejection fraction (EF), and distance in six-minute walk test (6MWP) (all p < 0.001). Patients treated with the highest dose of sacubitril/valsartan exhibited the greatest benefits. The safety profile was favorable and consistent with that previously reported; however, therapy discontinuation due to side effects occurred in 11% of patients. The independent predictors for composite endpoint (n = 24, 26.9%) were history of HF hospitalization, tricuspid annular plane systolic excursion (TAPSE) and angiotensin-converting-enzyme inhibitor (ACEI)-naive patients. CONCLUSIONS: Treatment of chronic HFrEF patients with sacubitril/valsartan is safe and is associated with significant clinical and objective improvement. The non-survivors had more advanced HF, so the initiation and uptitration of sacubitril/valsartan should be done early.


Assuntos
Aminobutiratos/uso terapêutico , Insuficiência Cardíaca , Tetrazóis/uso terapêutico , Idoso , Antagonistas de Receptores de Angiotensina/efeitos adversos , Combinação de Medicamentos , Feminino , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Volume Sistólico , Valsartana
20.
Adv Clin Exp Med ; 30(1): 87-92, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33529512

RESUMO

BACKGROUND: Acute kidney injury (AKI) is a common feature in adults undergoing allogeneic hematopoietic stem cell transplantation (alloHSCT). However, accurate assessment of AKI incidence in the pediatric population still seems a challenge. OBJECTIVES: To evaluate the incidence of AKI according to the pRIFLE criteria in children undergoing alloHSCT, with special focus on differences between patients transplanted due to oncological and non-oncological indications. MATERIAL AND METHODS: A retrospective analysis of data, concerning 135 children undergoing alloHSCT due to oncological (89 patients) or other (46 patients) reasons, was performed. The values of estimated glomerular filtration rate (eGFR) were measured before alloHSCT, 24 h after, 1, 2, 3, 4, 8 weeks, 3 and 6 months after alloHSCT, and the AKI incidence was analyzed. RESULTS: Acute kidney injury was diagnosed in 54% of all patients. The Risk stage (R) was noticed at least once in 46% of oncological and 37% of non-oncological children. The Injury stage (I) concerned 12% of oncological and 6% of non-oncological patients undergoing alloHSCT. The incidence of AKI in both groups was comparable. The mean eGFR values in oncological children were higher than those in the non-oncological patients even before transplantation and until the 4th week after alloHSCT. The eGFR increased significantly in all patients 24 h after alloHSCT and returned to pre-transplantation records after 2-3 weeks. Then, oncological patients demonstrated a gradual decrement of eGFR. Six months after transplantation, eGFR values in oncological children were significantly lower compared to pre-transplantation records, whereas in non-oncological children, these values were comparable. CONCLUSIONS: Although the type of indication for alloHSCT has no impact on the AKI incidence, children undergoing alloHSCT due to oncological reasons are at greater risk of renal impairment 6 months after transplantation than non-oncological patients.


Assuntos
Lesão Renal Aguda , Transplante de Células-Tronco Hematopoéticas , Lesão Renal Aguda/diagnóstico , Lesão Renal Aguda/epidemiologia , Lesão Renal Aguda/etiologia , Criança , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Incidência , Projetos Piloto , Estudos Retrospectivos , Fatores de Risco
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