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1.
Eur. j. psychol. appl. legal context (Internet) ; 12(2): 85-92, jul.-dic. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-190653

RESUMO

Antisocial behaviors in adolescents are present and prevalent around the world and have harmful consequences for individuals and societies. The research focused on antisocial behaviors in young people has been very fruitful, but studies are usually fragmented and focused on specific problem behaviors either in school or outside of school. Although victim-offender overlap was described in many studies, most projects focused either on victims or on offenders. This prospective longitudinal study was conducted to discover patterns of antisocial behavior from a comprehensive perspective, including different problem behaviors in and out of schools, focusing on both victimization and offending. A sample of 450 early adolescents was followed-up during one school year. Latent class and latent transition analyses were performed and identified four groups of students. These groups were: low antisocial, highly antisocial and victimized, high bullying victimization, and high offending outside of school. Transition analyses showed that the low antisocial and offenders outside of school groups were relatively stable over time. Students in the high bullying victimization group transitioned to different groups, and students in the highly antisocial and victimized group either remained in the highly antisocial group or transitioned to high offending outside of school. Findings suggest that single antisocial behaviors are not common and students who display one problem behavior usually display other problem behaviors. Early adolescents who are involved in antisocial behaviors in one time period frequently remain involved one year later. It is therefore possible that the antisocial potential of some adolescents is expressed in different contexts. This has important implications for research and practice that need to adopt a more holistic and comprehensive approach


Las conductas antisociales de los adolescentes están presentes en todo el mundo y tienen consecuencias perjudiciales para individuos y sociedades. La investigación centrada en las conductas antisociales de los jóvenes ha sido muy fructífera, pero los estudios están generalmente fragmentados y se centran en comportamientos problemáticos específicos, ya sea en la escuela o fuera de la escuela. Aunque la superposición víctima-agresor se ha descrito en muchos estudios, la mayoría se ha centrado en las víctimas o en los agresores. Este estudio longitudinal prospectivo se ha realizado para descubrir patrones de conducta antisocial desde una perspectiva integral, que incluye diferentes comportamientos problemáticos dentro y fuera de la escuela, centrándose tanto en la victimización como en la agresión. Se ha seguido una muestra de 450 estudiantes durante un año escolar y se han realizado análisis de clases latentes y de transiciones latentes, identificando cuatro grupos de estudiantes: bajo antisocial, altamente antisocial y victimizado, alta victimización por bullying y alto en ofensas fuera de la escuela. Los análisis de transición mostraron que el grupo bajo antisocial y el grupo alto en ofensas fuera de la escuela eran relativamente estables en el tiempo. Los estudiantes del grupo alta victimización por bullying hicieron la transición a diferentes grupos y los estudiantes del grupo altamente antisocial y victimizado permanecieron en su grupo o pasaron al grupo alto en ofensas fuera de la escuela. Los resultados indican que no son frecuentes las conductas antisociales aisladas y que los estudiantes que muestran un comportamiento problemático, generalmente, presentan otros comportamientos problemáticos. Los adolescentes que están implicados en conductas antisociales en un momento temporal con frecuencia siguen implicados un año después. Por lo tanto, es posible que el potencial antisocial de algunos adolescentes se exprese en diferentes contextos. El estudio tiene importantes implicaciones para la investigación y la práctica, ya que tienen que adoptar un enfoque más holístico e integral


Assuntos
Humanos , Masculino , Feminino , Adolescente , Transtorno da Personalidade Antissocial/psicologia , Comportamento do Adolescente/psicologia , Bullying/psicologia , Estudos Longitudinais , Estudos Prospectivos
2.
Int. j. clin. health psychol. (Internet) ; 20(3): 183-191, sept.-dic. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-190835

RESUMO

BACKGROUND/OBJECTIVE: The outbreak of COVID-19 and the lack of vaccine made extraordinary actions such as social distancing necessary. While some individuals experience the restrictions on daily life as a heavy burden, others adapt to the situation and try to make the best of it. The present longitudinal study investigated the extent and predictors of the burden induced by the outbreak of COVID-19 in Germany. METHOD: Data were assessed in October 2019 using the DASS-21 and the PMH-Scale, and in March 2020 adding a six-item measure of burden and a 2-item rating of sense of control. RESULTS: In a sample of 436 participants, about 28% stayed in self-quarantine, 22 persons had relevant symptoms and one person was positively tested for COVID-19. Most participants experienced medium to high levels of burden but tried to make the best of it. Stress symptoms in 2019 predicted a higher level of burden and PMH predicted a lower level of burden in March 2020. Remarkably, depression and anxiety symptoms did not significantly predict burden. The protective effect of PMH and the negative impact of stress symptoms were mediated by perceived sense of control. CONCLUSIONS: The results emphasize the protective effect of PMH in extraordinary situations such as the current outbreak of COVID-19


ANTECEDENTES/OBJETIVO: El brote COVID-19 y la falta de vacuna hicieron necesarias acciones extraordinarias como la distancia social. Algunas personas experimentan las restricciones en la vida diaria como sobrecarga emocional y otras se adaptan a la situación, tratando de sacar lo mejor de ella. Se investigó el alcance y predictores de sobrecarga emocional inducida por el COVID-19 en Alemania. MÉTODO: Se evaluaron niveles de estrés y salud mental positiva en octubre de 2019 con DASS-21 y Escala-PMH, y en marzo de 2020, agregando medidas de sobrecarga emocional y percepción de control. RESULTADOS: En una muestra de 436 participantes, el 28% permaneció en cuarentena, 22 personas tuvieron síntomas relevantes y una dio positivo en COVID-19. La mayoría experimentaron niveles de sobrecarga emocional medio-alto, aunque trataron de sobrellevar la situación lo mejor posible. Los síntomas de estrés en octubre 2019 predijeron un nivel de sobrecarga más elevado en marzo 2020 y, contrariamente, los niveles de salud mental positiva en octubre 2019 predijeron un menor nivel de sobrecarga emocional en marzo 2020. Sorprendentemente, los síntomas de depresión y ansiedad no predijeron la sensación de sobrecarga posterior. El efecto protector de la salud mental positiva y el impacto negativo de los síntomas de estrés fueron mediados por la percepción de control. CONCLUSIONES: Se resalta el efecto protector de la salud mental positiva en situaciones extraordinarias como el brote COVID-19


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/psicologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/psicologia , Pandemias , Quarentena/psicologia , Adaptação Psicológica , Estresse Psicológico/psicologia , Depressão/psicologia , Ansiedade/psicologia , Estudos Longitudinais , Estudos Prospectivos , Alemanha Ocidental/epidemiologia
4.
Rev. esp. anestesiol. reanim ; 67(8): 425-437, oct. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192474

RESUMO

ANTECEDENTES: No se ha reportado plenamente la evolución clínica de los pacientes críticos de COVID-19 durante su ingreso en la unidad de cuidados intensivos (UCI), incluyendo las complicaciones médicas e infecciosas y terapias de soporte, así como su asociación con la mortalidad en ICU. OBJETIVO: El objetivo de este estudio es describir las características clínicas y la evolución de los pacientes ingresados en UCI por COVID-19, y determinar los factores de riesgo de la mortalidad en UCI de dichos pacientes. MÉTODOS: Estudio prospectivo, multi-céntrico y de cohorte, que incluyó a los pacientes críticos de COVID-19 ingresados en 30 UCIs de España y Andorra. Se incluyó a los pacientes consecutivos de 12 de Marzo a 26 de Mayo de 2020 si habían fallecido o habían recibido el alta de la UCI durante el periodo de estudio. Se reportaron los datos demográficos, síntomas, signos vitales, marcadores de laboratorio, terapias de soporte, terapias farmacológicas, y complicaciones médicas e infecciosas, realizándose una comparación entre los pacientes fallecidos y los pacientes dados de alta. RESULTADOS: Se incluyó a un total de 663 pacientes. La mortalidad general en UCI fue del 31% (203 pacientes). Al ingreso en UCI los no supervivientes eran más hipoxémicos [SpO2 sin mascarilla de no reinhalación, de 90 (RIC 83-93) vs 91 (RIC 87-94); p < 0,001] y con mayor puntuación en la escala SOFA - Evaluación de daño orgánico secuencial - [SOFA, 7 (RIC 5-9) vs 4 (RIC 3-7); p < 0,001]. Las complicaciones fueron más frecuentes en los no supervivientes: síndrome de distrés respiratorio agudo (SDRA) (95% vs 89%; p = 0,009), insuficiencia renal aguda (IRA) (58% vs 24%; p < 10−16), shock (42% vs 14%; p < 10−13), y arritmias (24% vs 11%; p < 10−4). Las súper-infecciones respiratorias, infecciones del torrente sanguíneo y los shock sépticos fueron más frecuentes en los no supervivientes (33% vs 25%; p = 0,03, 33% vs 23%; p = 0,01 y 15% vs 3%, p = 10−7), respectivamente. El modelo de regresión multivariable reflejó que la edad estaba asociada a la mortalidad, y que cada año incrementaba el riesgo de muerte en un 1% (95%IC: 1-10, p = 0,014). Cada incremento de 5 puntos en la escala APACHE II predijo de manera independiente la mortalidad [OR: 1,508 (1,081, 2,104), p = 0,015]. Los pacientes con IRA [OR: 2,468 (1,628, 3,741), p < 10−4)], paro cardiaco [OR: 11,099 (3,389, 36,353), p = 0,0001], y shock séptico [OR: 3,224 (1,486, 6,994), p = 0,002] tuvieron un riesgo de muerte incrementado. CONCLUSIONES: Los pacientes mayores de COVID-19 con puntuaciones APACHE II más altas al ingreso, que desarrollaron IRA en grados II o III y/o shock séptico durante la estancia en UCI tuvieron un riesgo de muerte incrementado. La mortalidad en UCI fue del 31%


BACKGROUND: The clinical course of COVID-19 critically ill patients, during their admission in the intensive care unit (UCI), including medical and infectious complications and support therapies, as well as their association with in-ICU mortality has not been fully reported. OBJECTIVE: This study aimed to describe clinical characteristics and clinical course of ICU COVID-19 patients, and to determine risk factors for ICU mortality of COVID-19 patients. METHODS: Prospective, multicentre, cohort study that enrolled critically ill COVID-19 patients admitted into 30 ICUs from Spain and Andorra. Consecutive patients from March 12th to May 26th, 2020 were enrolled if they had died or were discharged from ICU during the study period. Demographics, symptoms, vital signs, laboratory markers, supportive therapies, pharmacological treatments, medical and infectious complications were reported and compared between deceased and discharged patients. RESULTS: A total of 663 patients were included. Overall ICU mortality was 31% (203 patients). At ICU admission non-survivors were more hypoxemic [SpO2 with non-rebreather mask, 90 (IQR 83-93) vs 91 (IQR 87-94); p < 0.001] and with higher sequential organ failure assessment score [SOFA, 7 (IQR 5-9) vs 4 (IQR 3-7); p < 0.001]. Complications were more frequent in non-survivors: acute respiratory distress syndrome (ARDS) (95% vs 89%; p = 0.009), acute kidney injury (AKI) (58% vs 24%; p < 10−16), shock (42% vs 14%; p < 10−13), and arrhythmias (24% vs 11%; p < 10−4). Respiratory super-infection, bloodstream infection and septic shock were higher in non-survivors (33% vs 25%; p = 0.03, 33% vs 23%; p = 0.01 and 15% vs 3%, p = 10−7), respectively. The multivariable regression model showed that age was associated with mortality, with every year increasing risk-of-death by 1% (95%CI: 1-10, p = 0.014). Each 5-point increase in APACHE II independently predicted mortality [OR: 1.508 (1.081, 2.104), p = 0.015]. Patients with AKI [OR: 2.468 (1.628, 3.741), p < 10−4)], cardiac arrest [OR: 11.099 (3.389, 36.353), p = 0.0001], and septic shock [OR: 3.224 (1.486, 6.994), p = 0.002] had an increased risk-of-death. CONCLUSIONS: Older COVID-19 patients with higher APACHE II scores on admission, those who developed AKI grades II or III and/or septic shock during ICU stay had an increased risk-of-death. ICU mortality was 31%


Assuntos
Humanos , Infecções por Coronavirus/mortalidade , Síndrome Respiratória Aguda Grave/mortalidade , Vírus da SARS/patogenicidade , Estudos Prospectivos , Unidades de Terapia Intensiva/estatística & dados numéricos , Mortalidade Hospitalar/tendências , Índice de Gravidade de Doença
5.
J Contemp Dent Pract ; 21(6): 701-709, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33025943

RESUMO

AIM: To systematically review the comparative differences in the performance and timeliness of conventional orthodontic treatment with that of corticotomy-assisted accelerated orthodontic treatment. DATA SOURCES: The electronic databases PubMed and Google Scholar were searched from January 2007 to January 2018 in English, with manual searches of reference lists and gray literature. Thirty-six articles were included in the study with inclusion criteria as prospective clinical studies of patients treated with fixed conventional appliance and the intervention was the corticotomy-assisted accelerated orthodontic treatment method. STUDY SELECTION: Two reviewers assessed independently the eligibility of the included articles. One investigator abstracted study design information, intervention details, and harms data from all included studies into a standardized evidence table. The accuracy of these data was checked by the second investigator. We resolved any disagreements through discussion with other authors. RESULTS: Different aspects of the corticotomy-assisted accelerated orthodontics treatment method were investigated including risk factors, advantages, and disadvantages as compared to that of conventional orthodontic treatment. CONCLUSION: There is limited available evidence about effectiveness of corticotomy-assisted accelerated orthodontics. Although the current review indicates that the corticotomy-assisted accelerated orthodontic treatment method can fasten the treatment duration by 2.2-3 folds compared to conventional orthodontic treatment, furthermore, the level of evidence needs well-conducted prospective research with big sample size to draw valid conclusions. CLINICAL SIGNIFICANCE: Orthodontic treatment is a time-consuming process and due to noncompliance of patients, research has found different methods to accelerate the treatment, thus reducing the total treatment duration. Use of accelerated orthodontic techniques is expected to help clinicians in better treatment decisions for noncompliant patients.


Assuntos
Ortodontia , Técnicas de Movimentação Dentária , Assistência Odontológica , Humanos , Aparelhos Ortodônticos Fixos , Estudos Prospectivos
6.
Artigo em Inglês | MEDLINE | ID: mdl-33007804

RESUMO

INTRODUCTION: Coronavirus disease (COVID-19), announced as a pandemic by the World Health Organization, recently has dominated people's lifestyle. The impact of COVID-19 seems to be relevant to the sexual health as well. METHODS: This prospective study was conducted on two occasions involving 764 female patients between March and April 2020-before and during the time of social quarantine. The sexual function was assessed using the Polish version of the Female Sexual Function Index (FSFI). Every patient filled out the survey concerning socio-demographic characteristics as well as the influence of SARS-CoV-2 pandemic on their lives. RESULTS: The overall FSFI score before the pandemic was 30.1 ± 4.4 and changed to 25.8 ± 9.7 during it. Scores of every domain: desire, arousal, lubrication, orgasm, satisfaction and pain decreased as well (p < 0.001). There was statistically significant association between the workplace and the change of FSFI scores before and during COVID-19 pandemic (p < 0.01). We noticed the biggest decrease in FSFI score in the group of women who did not work at all (5.2 ± 9.9). Religion had a statistically important impact on level of anxiety (p < 0.01). CONCLUSION: The main finding of our study was the influence of COVID-19 pandemic on the quality of sexual lifestyle and frequency of intercourse among Polish women.


Assuntos
Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Saúde Sexual , Ansiedade , Betacoronavirus , Infecções por Coronavirus/psicologia , Feminino , Humanos , Pandemias , Pneumonia Viral/psicologia , Polônia , Estudos Prospectivos , Local de Trabalho
7.
J Cardiothorac Surg ; 15(1): 296, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008451

RESUMO

BACKGROUND: The Surgical Pleth Index (SPI) is a monitoring method that reflects painful stimuli during general anesthesia, and dexmedetomidine is an analgesic adjuvant with an opioid-sparing effect. But up to now, it is still unclear whether dexmedetomidine has any influence on SPI. To investigate whether dexmedetomidine has an effect on SPI during video-assisted thoracoscopic surgery. METHODS: We enrolled 94 patients who underwent video-assisted thoracoscopic lung lobectomy. Patients were randomly assigned to a dexmedetomidine group (dexmedetomidine: 0.8 µg/kg administered for 10 min before anesthesia) or normal saline group (equal volume of normal saline). SPI and vital signs were recorded. The number rating scale (NRS) pain score was also evaluated. RESULTS: SPI values were significantly lower in the dexmedetomidine group than in the normal saline group at intubation and at discharge from the postanesthesia care unit. Compared with the normal saline group, mean arterial pressure and heart rate were both significantly lower in the dexmedetomidine group at intubation. Heart rate was lower at skin incision in the dexmedetomidine group. The NRS score in the normal saline group was noticeably higher vs. the dexmedetomidine group at discharge from the postanesthesia care unit. CONCLUSIONS: Dexmedetomidine decreased intraoperative SPI and NRS scores. Our results showed that dexmedetomidine attenuated noxious stimuli. TRIAL REGISTRATION: Chinese Clinical Trial Registry (ChiCTR): ChiCTR-OOC-16009450 , Registered 16 October, 2016.


Assuntos
Analgésicos não Entorpecentes/uso terapêutico , Dexmedetomidina/uso terapêutico , Pneumopatias/cirurgia , Adolescente , Adulto , Idoso , Anestesia Geral , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Cuidados Intraoperatórios , Masculino , Pessoa de Meia-Idade , Dor Pós-Operatória , Pneumonectomia , Estudos Prospectivos , Cirurgia Torácica Vídeoassistida , Adulto Jovem
8.
Prog Orthod ; 21(1): 37, 2020 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-33015719

RESUMO

OBJECTIVES: Adults with fixed orthodontic appliances are increasing nowadays. Compared with adolescents, adults present biological differences that might influence treatment duration. Therefore, the aim of the study was to compare duration of treatment with fixed appliances between adults and adolescents. MATERIALS AND METHODS: Eight databases were searched up to September 2019 for randomized and non-randomized clinical studies comparing treatment duration with fixed appliances in adolescents and adult patients. After duplicate study selection, data extraction, and risk of bias assessment with the Cochrane ROBINS-I tool, random effects meta-analyses of mean differences (MD) and their 95% confidence intervals (CIs) were performed, followed by assessment of the quality of evidence with GRADE. RESULTS: A total of 11 unique studies (one prospective and 10 retrospective non-randomized) with 2969 adolescents and 1380 adult patients were finally included. Meta-analysis of 7 studies found no significant difference in the duration of comprehensive treatment with fixed appliances (MD = - 0.8 month; 95% CI = - 4.2 to 2.6 months; P = 0.65; I2 = 92%) between adults and adolescents. Similarly, both distalization of upper first molars with skeletal anchorage for class II correction and the retraction of canines into the premolar extraction spaces lasted similarly long among adults and adolescents. On the other hand, alignment of palatally displaced canines lasted considerably longer in adults compared to adolescents (1 study; MD = 3.8 months; 95% CI = 1.4 to 6.2 months; P = 0.002). The quality of evidence for the meta-analysis was low due to the inclusion of non-randomized studies with considerable risk of bias. CONCLUSIONS: While existing evidence does not indicate a difference in the overall duration of treatment with fixed appliances between adults and adolescents, the alignment of palatally displaced canines lasted significantly longer in adults. However, our confidence in these estimates is low due to the risk of bias in the included studies. TRIAL REGISTRATION: PROSPERO: ( CRD42019148169 ).


Assuntos
Dente Molar , Aparelhos Ortodônticos Fixos , Adolescente , Adulto , Duração da Terapia , Humanos , Estudos Prospectivos , Estudos Retrospectivos
9.
Beijing Da Xue Xue Bao Yi Xue Ban ; 52(5): 948-951, 2020 Oct 18.
Artigo em Chinês | MEDLINE | ID: mdl-33047735

RESUMO

OBJECTIVE: To assess the effects of loupes and microscope on the posture of prosthodontists when preparing the laminate veneer, and to assess the clinical value of loupes and microscope from the ergonomic aspects. METHODS: Twenty young prosthodontists from Department of Prosthodontics, Peking University School and Hospital of Stomatology were recruited into this study, which was a prospective, single blind, self-control trials. The research hypothesis was concealed and the participants were deceived about the precise purpose of the study to counterbalance the lack of direct blinding. The prosthodontists prepared laminate veneers of open window type in the artificial dental model, under routine visual field (control group), 2.5× headwear loupes (loupes group), and 8× operating microscope (microscopic group) by turning. The participants were photographed from profile view and front view. Thereafter, the subjective assessment was performed by themselves using the visual analogue score (VAS). The expert assessment was performed by two professors using modified-dental operator posture assessment instrument on the basis of photographs of the profile view and front view. RESULTS: The subjective assessment scores for the control group, loupes group and microscopic group were 4.55±1.96, 7.90±1.12, and 9.00±0.92, respectively. There was significant difference between the three groups' subjective scores (P < 0.05). The expert assessment scores for the control group, loupes group and microscopic group were 16.38±1.52, 15.15±1.30, and 13.60±0.88, respectively. There was significant difference between the three groups' expert assessment scores (P < 0.05). Specifically, the three groups' expert assessment scores were significantly different (P < 0.05) in trunk position (front to back) (1.33±0.41, 1.03±0.11, 1.00±0.00), head and neck position (front to back) (2.75±0.38, 2.13±0.36, 1.23±0.38), elbows level (1.38±0.43, 1.40±0.45, 1.13±0.22), and shoulders level (1.43±0.41, 1.23±0.34, 1.13±0.28). Thereinto, the microscopic group was better than loupes group in head and neck position (front to back) and elbows level (P < 0.05). CONCLUSION: Loupes and microscope improve the posture of the prosthodontist when preparing the laminate veneer, in which the microscope is better than loupes. Therefore, the magnification devices have clinical value from the ergonomic aspects.


Assuntos
Ergonomia , Postura , Odontólogos , Humanos , Estudos Prospectivos , Método Simples-Cego
10.
Ned Tijdschr Tandheelkd ; 127(9): 468-471, 2020 Sep.
Artigo em Holandês | MEDLINE | ID: mdl-33011751

RESUMO

Many, mostly older patients suffer from osteoporosis: a chronic skeletal disease causing bone to become more porous and less strong. 2 recent systematic reviews and one long-term prospective multicentre case-control study showed that placing implants in osteoporosis patients is not contraindicated. From these studies it can be concluded that results comparable to those with patients who do not suffer from osteoporosis can be reached. Osseointegration, implant survival rate, marginal bone loss and mucosal parameters do not behave differently than they do in the healthy group of patients.


Assuntos
Implantes Dentários/efeitos adversos , Osteoporose/epidemiologia , Estudos de Casos e Controles , Humanos , Estudos Prospectivos , Fatores de Risco
12.
Pan Afr Med J ; 36: 257, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33014253

RESUMO

Since asymptomatic infections as "covert transmitter", and some patients can progress rapidly in the short term, it is essential to pay attention to the diagnosis and surveillance of asymptomatic patients with SARS-COV2 infection. CT scan has great value in screening and detecting patients with COVID-19 pneumonia, especially in the highly suspected or probable asymptomatic cases with negative RT-PCR for SARS-COV2. This study aimed to detect incidentally COVID-19 pneumonia on medical imaging for patients consulting for other reasons.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico por imagem , Pulmão/diagnóstico por imagem , Pandemias , Pneumonia Viral/diagnóstico por imagem , Dor Abdominal/complicações , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doenças Assintomáticas , Lesões Encefálicas/complicações , Dor no Peito/complicações , Criança , Pré-Escolar , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Feminino , Humanos , Achados Incidentais , Linfadenopatia/diagnóstico por imagem , Linfadenopatia/etiologia , Masculino , Pessoa de Meia-Idade , Derrame Pleural/diagnóstico por imagem , Derrame Pleural/etiologia , Pneumonia Viral/complicações , Estudos Prospectivos , Tomografia Computadorizada por Raios X/métodos , Tunísia/epidemiologia , Adulto Jovem
14.
Rev Saude Publica ; 54: 94, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027344

RESUMO

OBJECTIVE: To perform a cost-benefits analysis of a clinical pharmacy (CP) service implemented in a Neurology ward of a tertiary teaching hospital. METHODS: This is a cost-benefit analysis of a single arm, prospective cohort study performed at the adult Neurology Unit over 36 months, which has evaluated the results of a CP service from a hospital and Public Health System (PHS) perspective. The interventions were classified into 14 categories and the costs identified as direct medical costs. The results were analyzed by the total and marginal cost, the benefit-cost ratio (BCR) and the net benefit (NB). RESULTS: The total 334 patients were followed-up and the highest occurrence in 506 interventions was drug introduction (29.0%). The marginal cost for the hospital and avoided cost for PHS was US$182±32 and US$25,536±4,923 per year; and US$0.55 and US$76.4 per patient/year. The BCR and NB were 0.0, -US$26,105 (95%CI -31,850 - -10,610), -US$27,112 (95%CI -33,160-11,720) for the hospital and; 3.0 (95%CI 1.97-4.94), US$51,048 (95%CI 27,645-75,716) and, 4.6 (95%CI 2.24-10.05), US$91,496 (95%CI 34,700-168,050; p < 0.001) for the PHS, both considering adhered and total interventions, respectively. CONCLUSIONS: The CP service was not directly cost-benefit at the hospital perspective, but it presented savings for forecast cost related to the occurrence of preventable morbidities, measuring a good cost-benefit for the PHS.


Assuntos
Serviço de Farmácia Hospitalar/economia , Adulto , Brasil , Análise Custo-Benefício , Hospitais Universitários , Humanos , Estudos Prospectivos
15.
Rev Lat Am Enfermagem ; 28: e3364, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33027402

RESUMO

OBJECTIVE: to analyze the relationship between maternal self-efficacy to breastfeed and sociodemographic, obstetric, and neonatal variables; between the duration of exclusive breastfeeding and sociodemographic variables; and between the breastfeeding self-efficacy and the duration of exclusive breastfeeding at the intervals of 30, 60, and 180 days postpartum. METHOD: a longitudinal and prospective study conducted with 224 women. A sociodemographic questionnaire, the Breastfeeding Self-Efficacy Scale - Short Form, and a questionnaire on breastfeeding and child feeding were used for collecting the data. Fisher's exact test and Pearson's correlation coefficient test were used for analysis. RESULTS: there was no association between breastfeeding self-efficacy and the duration of exclusive breastfeeding identified at 30, 60, and 180 days. Self-efficacy was associated with the type of delivery and complications in the postpartum period. There was also an association between religion and exclusive breastfeeding 30 and 60 days postpartum, and assistance with baby care and exclusive breastfeeding at 60 days. CONCLUSION: It was identified that the type of delivery, complications in the postpartum period, religion, and assistance with baby care corroborate to increase maternal confidence in the ability to breastfeed.


Assuntos
Aleitamento Materno , Autoeficácia , Adulto , Criança , Feminino , Humanos , Mães , Período Pós-Parto , Gravidez , Estudos Prospectivos
18.
Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi ; 34(9): 836-839;843, 2020 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-33040510

RESUMO

Objective:A prospective randomized controlled study of patients with thyroid papillary carcinoma requiring lateral neck dissection was conducted to investigate the thoroughness, safety and cosmetic features of endoscope-assisted lateral neck dissection. Method:Patients who underwent total thyroidectomy, bilateral central lymph node dissection and unilateral lateral neck dissection for papillary thyroid cancer were randomly divided into two groups: endoscopic assisted group and open group, 18 cases in each group. The clinical characteristics, operation conditions, postoperative complications and aesthetic satisfaction of the two groups were compared. Result:There were no statistically significant differences between the endoscopic group and the open group in age, gender, tumor size, dissection side, operation time, postoperative hospital stay, number of lymph nodes to be dissected, number of metastatic lymph nodes, postoperative hoarseness, and hypoparathyroidism(P>0.05); No hematoma or lymphatic leakage occurred in the two groups after surgery, and no tumor recurrence or residual was found in the ultrasound review at 6 months after surgery. Serum Tg level in the endoscopic group was higher than that in the open group at 6 months after surgery, but the difference between the two groups was not statistically significant(P>0.05); The neck pain score at day 3 after operation, the neck numbness and discomfort score at month 1 after operation, and the aesthetic satisfaction score at 3 months after operation in the endoscope assisted group were better than that in the open group(P<0.05). Conclusion:Endoscope-assisted lateral neck dissection is safe, feasible and with excellent cosmetic effect for the treatment of lymph node metastasis in the lateral cervical region of papillary thyroid carcinoma.


Assuntos
Carcinoma Papilar , Câncer Papilífero da Tireoide , Neoplasias da Glândula Tireoide , Carcinoma Papilar/cirurgia , Humanos , Recém-Nascido , Linfonodos , Metástase Linfática , Esvaziamento Cervical , Estudos Prospectivos , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia
19.
Crit Care ; 24(1): 605, 2020 10 12.
Artigo em Inglês | MEDLINE | ID: mdl-33046113

RESUMO

BACKGROUND: Systemic inflammation in COVID-19 often leads to multiple organ failure, including acute kidney injury (AKI). Renal replacement therapy (RRT) in combination with sequential extracorporeal blood purification therapies (EBP) might support renal function, attenuate systemic inflammation, and prevent or mitigate multiple organ dysfunctions in COVID-19. AIM: Describe overtime variations of clinical and biochemical features of critically ill patients with COVID-19 treated with EBP with a hemodiafilter characterized by enhanced cytokine adsorption properties. METHODS: An observational prospective study assessing the outcome of patients with COVID-19 admitted to the ICU (February to April 2020) treated with EBP according to local practice. Main endpoints included overtime variation of IL-6 and multiorgan function-scores, mortality, and occurrence of technical complications or adverse events. RESULTS: The study evaluated 37 patients. Median baseline IL-6 was 1230 pg/ml (IQR 895) and decreased overtime (p < 0.001 Kruskal-Wallis test) during the first 72 h of the treatment, with the most significant decrease in the first 24 h (p = 0.001). The reduction in serum IL-6 concentrations correlated with the improvement in organ function, as measured in the decrease of SOFA score (rho = 0.48, p = 0.0003). Median baseline SOFA was 13 (IQR 6) and decreased significantly overtime (p < 0.001 at Kruskal-Wallis test) during the first 72 h of the treatment, with the most significant decrease in the first 48 h (median 8 IQR 5, p = 0.001). Compared to the expected mortality rates, as calculated by APACHE IV, the mean observed rates were 8.3% lower after treatment. The best improvement in mortality rate was observed in patients receiving EBP early on during the ICU stay. Premature clotting (running < 24 h) occurred in patients (18.9% of total) which featured higher effluent dose (median 33.6 ml/kg/h, IQR 9) and higher filtration fraction (median 31%, IQR 7.4). No electrolyte disorders, catheter displacement, circuit disconnection, unexpected bleeding, air, or thromboembolisms due to venous cannulation of EBP were recorded during the treatment. In one case, infection of vascular access occurred during RRT, requiring replacement. CONCLUSIONS: EBP with heparin-coated hemodiafilter featuring cytokine adsorption properties administered to patients with COVID-19 showed to be feasible and with no adverse events. During the treatment, patients experienced serum IL-6 level reduction, attenuation of systemic inflammation, multiorgan dysfunction improvement, and reduction in expected ICU mortality rate.


Assuntos
Infecções por Coronavirus/terapia , Citocinas/sangue , Hemodiafiltração/instrumentação , Hemodiafiltração/métodos , Pneumonia Viral/terapia , Infecções por Coronavirus/sangue , Humanos , Unidades de Terapia Intensiva , Pandemias , Projetos Piloto , Pneumonia Viral/sangue , Estudos Prospectivos , Resultado do Tratamento
20.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(9): 1109-1114, 2020.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33051426

RESUMO

OBJECTIVES: To investigate volume changes of subcortical structures in patients with post-hepatitis B cirrhosis. METHODS: Thirty patients with post-hepatitis B cirrhosis (the cirrhosis group) and 24 age- and sex-matched healthy controls (the control group) were enrolled in this prospective study. All subjects underwent neuropsychological tests, blood biochemical determinations, and cerebral MRI. Volumes of 18 selected subcortical structures were automatically segmented and analyzed by the FreeSurfer. In the cirrhosis group, the relationships between abnormal subcortical volumes and clinical index or neurocognitive performance were investigated. The relationships between globus pallidus volumes and pallidal hyperintensity were also examined. RESULTS: Compared with the healthy controls, patients with post-hepatitis B cirrhosis displayed smaller bilateral putamen, amygdala, and nucleus accumbens volumes and larger bilateral globus pallidus volumes (P<0.001 or P=0.001). In the cirrhosis group, the volumes of left putamen and amygdala were negatively correlated with the number connection test-A (NCT-A)(left putamen r=-0.410, P=0.034; left amygdala r=-0.439, P=0.022), and the volumes of bilateral globus pallidus were positively correlated with pallidal index (PI) (left globus pallidus r=0.889, P<0.001; right globus pallidus r=0.900, P<0.001). CONCLUSIONS: Abnormalities of subcortical volumes appear bilaterally symmetrical in patients with post-hepatitis B cirrhosis. Atrophy of left putamen and amygdala might contribute to poor neurocognitive performance, and the manganese deposition might contribute to the increased globus pallidus volumes in patients with post-hepatitis B cirrhosis.


Assuntos
Hepatite B , Imagem por Ressonância Magnética , Hepatite B/complicações , Hepatite B/diagnóstico por imagem , Humanos , Cirrose Hepática/diagnóstico por imagem , Testes Neuropsicológicos , Estudos Prospectivos
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