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1.
Eur. j. psychol. appl. legal context (Internet) ; 12(2): 69-75, jul.-dic. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-190651

RESUMO

This study analyses the psychosocial characteristics based on recidivism risk of juvenile offenders in conditions of internment. A sample of 102 juvenile offenders (92 male, 10 female) who were serving sentences in the only detention centre in Navarra (Spain) was used. Data on sociodemographic and psychosocial characteristics as well as features related to recidivism risk were collected through the Youth Level of Service/Case Management Inventory (YLS/CMI) and data on personality characteristics were obtained through the Millon Adolescent Clinical Inventory (MACI). The results showed that risk of reoffending was high for 21.6% of the sample, moderate for 31.4%, and low for 47.1%. Statistically significant differences were found between groups for various psychosocial and personality characteristics. In addition, the main variables related to the different risk levels of criminal recidivism were the presence/absence of history of violent behaviour, school performance, problem-solving skills, and submission as a personality trait. These four variables correctly classified 80.4% of the sample. According to the results, these variables must be considered in the development of effective intervention programmes in detention centres with juvenile offenders in order to decrease criminal reoffending rates


En este estudio se analizan las características psicosociales de una muestra de menores infractores en un centro de internamiento en función del riesgo de reincidencia. Se evaluó una muestra de 102 menores infractores (92 varones y 10 mujeres) que cumplían una medida judicial en el único centro de internamiento de Navarra (España). Se recogió información sobre las características sociodemográficas, psicosociales y el riesgo de reincidencia a través del Inventario para la Gestión y la Intervención con Jóvenes (IGI-J), así como sobre las características de personalidad a través del Inventario Clínico de Adolescentes de Millon (MACI). Los resultados mostraron que el riesgo de reincidencia era alto para el 21.6% de la muestra, moderado para el 31.4% y bajo para el 47.1%. Se encontraron diferencias estadísticamente significativas entre los grupos en numerosas características psicosociales y de personalidad. Además, las principales variables relacionadas con los diferentes niveles de riesgo de reincidencia fueron la presencia/ausencia de una historia de conductas violentas, el rendimiento escolar, las habilidades para la solución de problemas y la sumisión como características de personalidad. Estas cuatro variables clasificaban correctamente al 80.4% de la muestra. Con arreglo a los resultados encontrados, estas variables se deben tener en cuenta en el desarrollo de programas de intervención eficaces en los centros de internamiento con menores infractores con el objetivo de disminuir la tasa de reincidencia


Assuntos
Humanos , Masculino , Feminino , Adolescente , Transtornos da Personalidade , Delinquência Juvenil/psicologia , Reincidência/psicologia , Fatores Socioeconômicos , Estudos Retrospectivos , Fatores de Risco
2.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 55(5): 286-288, sept.-oct. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-192478

RESUMO

INTRODUCCIÓN: El síndrome de tormenta de citoquinas (STC) es una complicación muy grave de los pacientes con infección por SARS-CoV-2. El tratamiento y la evolución no están bien definidos. Nuestro objetivo es describir sus características clínicas, los tratamientos empleados y su evolución clínica. PACIENTES Y MÉTODO: Estudio retrospectivo observacional de pacientes consecutivos ingresados en el período comprendido entre el 23 de marzo y el 12 de abril de 2020 con infección por SARS-CoV-2 confirmada, con neumonía por estudio radiológico o tomografía de tórax, que cumplían criterios de STC y que recibieron tratamiento. Clasificamos a los pacientes en los que recibieron solo pulsos de glucocorticoides (GC), o pulsos de GC y tocilizumab. Determinamos niveles séricos de ferritina, PCR y dímeros-D. La variable final fue la supervivencia. RESULTADOS: Veintiún pacientes con una edad de 83 años (80-88 años). La ferritina media fue de 1.056 microg/L (317-3.553), la PCR de 115,8mg/dL (22-306) y los dímeros-D de 2,9mg/L (0,45-17,5). Todos los pacientes recibieron pulsos de GC y en 2 casos simultáneamente tocilizumab. El tiempo medio de seguimiento fue de 13,7 días (8-21). La mortalidad global fue del 38,1% (8/21pacientes). Los 2 pacientes que recibieron tocilizumab fallecieron. Los fallecidos presentaron niveles significativamente más elevados de ferritina (1.254 vs. 925microg/L; p = 0,045) y PCR (197,6 vs. 76mg/dL; p = 0,007). Al final del seguimiento se observó una disminución en los parámetros bioquímicos con ferritina de 727microg/L, PCR de 27mg/dl y dímeros-D de 1,18mg/L. En 13/21 pacientes (61,9%) el STC se controló sin necesidad de añadir otros tratamientos. CONCLUSIONES: La mortalidad del STC por SARS-CoV-2 es alta a pesar del tratamiento. Una mayor respuesta inflamatoria se asoció con una mayor mortalidad. Aunque parece que el uso precoz de pulsos de GC puede controlarlo, pudiendo disminuir la necesidad de uso de otros tratamientos, con el diseño del estudio y sus limitaciones, no se puede establecer esta conclusión


INTRODUCTION: Cytokine storm syndrome (CTS) is a serious complication of patients with SARS-CoV-2 infection. Treatment and evolution in octogenarians are not well defiREVned. Our objective is to describe its clinical characteristics, the treatments and its clinical evolution. PATIENTS AND METHOD: Retrospective observational study of consecutive patients admitted in the period between March 23 and April 12, 2020 with confirmed SARS-CoV-2 infection, with pneumonia by radiological study or chest tomography, whith STC criteria and who received treatment. We classified patients as those who received only glucocorticoid (GC) pulses, or GC and tocilizumab pulses. We determined serum levels of ferritin, CRP and D-dimers. The final variable was survival. RESULTS: 21 patients, (80-88 years). The mean ferritin was 1056 microg/L (317-3,553), CRP 115.8mg/dL (22-306) and D-dimers 2.9m/L (0.45-17.5). All patients received GC pulses and in 2 cases simultaneously tocilizumab. The mean follow-up time was 13.7 days (8-21). The overall mortality was 38.1% (8/21 patients). The 2 patients who received tocilizumab died. The deceased had significantly higher levels of ferritin (1,254 vs. 925microg/L; P=.045) and CRP (197.6 vs. 76mg / dL; P=.007). At the end of the follow-up, a decrease in the biochemical parameters was observed with ferritin of 727microg/L, CRP of 27mg/dl and D-dimers of 1.18mg/L. In 13/21 patients (61.9%), the CTS was controlled without the need to add other treatments. CONCLUSIONS: STC mortality from SARS-CoV-2 is high despite treatment. A greater inflammatory response was associated with a higher mortality. Although it seems that the early use of GC pulses could control it, and the use of other treatments such as tocilizumab shouldo be, with the study design and its limitations, this conclusion cannot be stablished


Assuntos
Humanos , Masculino , Feminino , Idoso de 80 Anos ou mais , Infecções por Coronavirus/imunologia , Pneumonia Viral/imunologia , Síndrome Respiratória Aguda Grave/imunologia , Vírus da SARS/patogenicidade , Citocinas/efeitos adversos , Inflamação/fisiopatologia , Glucocorticoides/administração & dosagem , Anticorpos Monoclonais Humanizados/uso terapêutico , Estudos Retrospectivos , Infecções por Coronavirus/epidemiologia , Epidemias , Mediadores da Inflamação/imunologia , Inflamação/imunologia , Ferritinas/efeitos dos fármacos , Linfo-Histiocitose Hemofagocítica/imunologia
3.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 39(5): 299-302, sept.-oct. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-192565

RESUMO

INTRODUCCIÓN: El 30 de enero de 2020 la organización mundial de la salud (OMS) declaró una emergencia internacional por la pandemia causada por un nuevo coronavirus. Existen algunas indicaciones oncológicas que tienen especial prioridad y se siguen realizando estudios a pesar de la situación actual. En estos estudios hemos encontrado hallazgos sospechosos de neumonía COVID-19 en pacientes asintomáticos. El objetivo de este trabajo es valorar la incidencia de estos hallazgos, describir sus características y valorar la evolución de los pacientes sospechosos. MATERIAL Y MÉTODOS: Se han revisado los estudios PET oncológicos realizados entre el 18 de marzo y el 8 de abril de 2020. Se han identificado los pacientes que presentaban hallazgos sugerentes de corresponder con un proceso infeccioso pulmonar de forma incidental en pacientes asintomáticos. Se han revisado las historias clínicas de estos pacientes para confirmar o descartar la infección por SARS-CoV-2. RESULTADOS: Durante el periodo especificado se realizaron un total de 129 estudios PET/TC con indicación oncológica. De ellos, en 11 (8,5%) se encontraron hallazgos sospechosos de proceso infeccioso pulmonar. Se trataba de 8 varones y 3 mujeres con edades comprendidas entre los 30 y los 79 años (media: 62,2). CONCLUSIONES: Los pacientes con COVID-19 pueden presentar escasos síntomas de la enfermedad, y en los estudios PET/TC se pueden detectar tanto pacientes presintomáticos como pacientes casi asintomáticos por lo que los médicos nucleares deben prestar especial atención en la valoración pulmonar de los estudios PET/TC


INTRODUCTION: On January 30, 2020, the World Health Organization (WHO) declared an international emergency due to the pandemic caused by a new coronavirus. There are some oncological indications that have special priority and studies are still being carried out despite the current situation. In these studies we have found suspicious findings of COVID-19 pneumonia in asymptomatic patients. The objective of this work is to assess the incidence of these findings, describe their characteristics and the evolution of suspected patients. MATERIAL AND METHODS: Oncological PET studies carried out in asymptomatic patients between March 18 and April 8, 2020 have been reviewed. Patients who presented findings suggestive of corresponding to an pulmonary infectious process were selected. Clinical findings have been reviewed to confirm or rule out SARS-CoV-2 infection. RESULTS: During the specified period, a total of 129 PET/CT studies were performed. Of these, 11 (8.5%) found suspicious findings of a pulmonary infectious process. These were 8 men and 3 women aged between 30 and 79 years (mean 62.2). CONCLUSIONS: Patients with COVID-19 can present few symptoms of the disease, and in PET/CT studies both presymptomatic and almost asymptomatic patients can be detected, so nuclear medicine physicians should take special attention to the pulmonary evaluation of PET/CT studies


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Tomografia Computadorizada com Tomografia por Emissão de Pósitrons/métodos , Pneumonia Viral/diagnóstico por imagem , Síndrome Respiratória Aguda Grave/diagnóstico por imagem , Vírus da SARS/isolamento & purificação , Estudos Retrospectivos , Infecções por Coronavirus/diagnóstico por imagem , Pandemias/estatística & dados numéricos , Reação em Cadeia da Polimerase/métodos , Avaliação de Sintomas/métodos , Infecções Assintomáticas/epidemiologia
4.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(8): 629-638, oct. 2020.
Artigo em Espanhol | IBECS | ID: ibc-188364

RESUMO

BACKGROUND AND OBJECTIVES: Spain is in a situation of indefinite lockdown due to the ongoing coronavirus disease 2019 (COVID-19) pandemic. One of the consequences of this lockdown is delays in medical and surgical procedures for common diseases. The aim of this study was to model the impact on survival of tumor growth caused by such delays in patients with squamous cell carcinoma (SCC) and melanoma. MATERIAL AND METHODS: Multicenter, retrospective, observational cohort study. We constructed an exponential growth model for both SCC and melanoma to estimate tumor growth between patient-reported onset and surgical excision at different time points. RESULTS: Data from 200 patients with SCC of the head and neck and 1000 patients with cutaneous melanoma were included. An exponential growth curve was calculated for each tumor type and we estimated tumor size after 1, 2, and 3 months of potential surgical delay. The proportion of patients with T3 SCC (diameter > 4 cm or thickness > 6 mm) increased from 41.5% (83 patients) in the initial study group to an estimated 58.5%, 70.5%, and 72% after 1, 2, and 3 months of delay. Disease-specific survival at 2, 5, and 10 years in patients whose surgery was delayed by 3 months decreased by 6.2%, 8.2%, and 5.2%, respectively. The proportion of patients with ultrathick melanoma (> 6 mm) increased from 6.9% in the initial study group to 21.9%, 30.2%, and 30.2% at 1, 2, and 3 months. Five-and 10-year disease-specific survival both decreased by 14.4% in patients treated after a potential delay of 3 months. CONCLUSIONS: In the absence of adequate diagnosis and treatment of SCC and melanoma in the current lockdown situation in Spain, we can expect tosee to a considerable increase in large and thick SCCs and melanomas. Efforts must be taken to encourage self-examination and facilitate access to dermatologists in order to prevent further delays


ANTECEDENTES Y OBJETIVOS: La pandemia del coronavirus COVID-19 ha provocado un confinamiento indefinido. Una posible consecuencia de esta situación es un retraso en los procedimientos asistenciales de las patologías comunes. El objetivo de este estudio es estimar el hipotético impacto en la supervivencia que tendría el aumento del tamaño tanto para los carcinomas de células escamosas (CCE) como de los melanomas. MATERIAL Y MÉTODO: Estudio observacional retrospectivo de cohortes multicéntrico. Se desarrolló un modelo de crecimiento exponencial para cada tumor basado en el tiempo de evolución que refiere el paciente. RESULTADOS: Se incluyeron un total de 200 pacientes con CCEs localizados en la cabeza y el cuello y 1000 pacientes con melanoma cutáneo. Se calculó una curva de crecimiento exponencial para cada tumor y se estimó el tamaño del tumor tras 1, 2 y 3 mes tras el diagnóstico. En la muestra, los CCE mayores de 4 cm o > 6 mm de grosor (definidos como T3) pasaron de 83 (41.5%) en el grupo de estudio real a una estimación de 58,5%, 70,5% y 72% tras 1, 2 y 3 meses de retraso quirúrgico estimado. Se estimó una disminución de la supervivencia específica de enfermedad (SEE) de un 6,2%, 8,2% y 5,2% a los 2, 5 y 10 años, respectivamente, tras tres meses de retraso. Para los melanomas, los melanomas ultragruesos (> 6 mm) pasaron del 6,9% en el grupo de estudio al 21,9%, 30,2% y 30,2% tras 1,2 y 3 meses de demora. La SEE a los 5 y 10 años del grupo de estudio descendió un 14,4% en ambos tiempos. CONCLUSIONES: En ausencia de un adecuado diagnóstico y tratamiento de los pacientes con CCE y melanoma en la actual situación de confinamiento en España, podemos llegar a asistir a un considerable aumento de los casos de CCE y melanomas gruesos y de gran tamaño. Se deben fomentar los esfuerzos para promocionar la autoexploración y facilitar el acceso a los dermatólogos para no aumentar la demora de estos pacientes. Palabras clave: melanoma, pronóstico, diagnóstico precoz, carcinoma de células escamosas cutáneo, COVID-19, confinamiento


Assuntos
Humanos , Masculino , Feminino , Idoso , Idoso de 80 Anos ou mais , Neoplasias de Células Escamosas/mortalidade , Melanoma/mortalidade , Neoplasias Cutâneas/mortalidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Betacoronavirus , Pandemias , Quarentena , Análise de Sobrevida , Estudos Retrospectivos , Estudos de Coortes
8.
Biomed Res Int ; 2020: 2854186, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33015160

RESUMO

Objectives: To evaluate the role of short-term low-dose glucocorticoids in mild COVID-19 patients. Methods: We conducted a retrospective, cross-sectional, single-center study in Kunming, China. A total of 33 mild COVID-19 cases were divided into two treatment groups (with and without glucocorticoids, methylprednisolone, were used in this setting), and the absolute value of peripheral blood lymphocyte count; CD3+, CD4+, and CD8+ T cell counts; and the time to achieve negative transformation of a nucleic acid pharyngeal swab were recorded. Peripheral blood lymphocyte and T cell counts were compared between the treatment group and 25 healthy individuals. At the point of time when there was a 50% accumulation conversion rate (positive to negative nucleic acid on pharyngeal swab), and the nucleic acid turned negative in half of the patients in two groups, the peripheral blood lymphocyte and T cell counts were compared between treatment groups. Results: The mean cumulative time for the 50% negative conversion rate of the nucleic acid in the pharyngeal swab was 17.7 ± 5.1 days and 13.9 ± 5.4 days in the glucocorticoid group and the nonglucocorticoid group, respectively. The absolute peripheral blood lymphocyte count and the T cell subset count in the glucocorticoid group were lower than those in the nonglucocorticoid group. When the nucleic acid turned negative in half of the patients, the absolute value of peripheral blood lymphocyte count and CD4+ T cells of the glucocorticoid group and the nonglucocorticoid group was not significantly different; the CD3+ and CD8+ T cells in the glucocorticoid group were lower than those in the nonglucocorticoid group. The absolute peripheral blood lymphocyte count, CD3+ T cells, and CD4+ T cells in the glucocorticoid group were lower than those of the healthy group during the whole disease period, and CD8+ T cells returned to normal at 19-21 days of the disease period. There was no significant difference between the nonglucocorticoid group and the healthy group for absolute peripheral blood lymphocyte and CD8+ T cells; moreover, CD3+ T cells and CD4+ T cells were lower in the nonglucocorticoid group than those in the healthy group from the day of admission to the 18th day and returned to normal at the period of 19-21 days. The absolute peripheral lymphocyte count (P = 0.048, effect size d = 0.727) and T cell subset count (CD3: P = 0.042, effect size d = 0.655; CD4: P < 0.01, effect size d = 0.599; and CD8: P = 0.034, effect size d = 0.550) in the nonglucocorticoid group were higher than those in the glucocorticoid group, and the difference between the groups was statistically significant. Conclusions: This study found that the use of short-term, low-dose glucocorticoids does not negatively influence the clinical outcome, without affecting the final clearance of viral nucleic acid in mild COVID-19 patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Glucocorticoides/administração & dosagem , Pneumonia Viral/tratamento farmacológico , Adolescente , Adulto , Betacoronavirus/isolamento & purificação , Criança , China/epidemiologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Estudos Transversais , Feminino , Humanos , Contagem de Linfócitos , Masculino , Metilprednisolona/administração & dosagem , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/imunologia , Pneumonia Viral/virologia , Estudos Retrospectivos , Subpopulações de Linfócitos T/imunologia , Fatores de Tempo , Resultado do Tratamento , Adulto Jovem
9.
J Contemp Dent Pract ; 21(6): 666-672, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-33025936

RESUMO

AIM: The development of a class II malocclusion is usually related to a reduced oropharyngeal airway space. In order to prevent airway obstruction, functional appliances are commonly used for orthodontic therapy. The aim of the article is to verify if these appliances could positively influence oropharyngeal diameters preventing the onset of future respiratory disorders. MATERIALS AND METHODS: A group of 10 patients treated at the Dental Clinic of San Gerardo Hospital in Monza with mandibular activator was selected. Ten similar untreated class II subjects with retrognathic mandible were used as control group. The cephalometric tracings were made on lateral teleradiographs of the skull before and after the active therapy with functional devices for the treated group and before and after growth peak for the control one. Descriptive statistical analysis was calculated for all the cephalometric values in both study cases and control group using Excel worksheet. The data distribution was evaluated with Shapiro-Wilk test and the in-between group discrepancies were evaluated with Mann-Whitney U test. RESULTS: At T1 period, both case and control groups showed a class II pattern. At T2 period, the study group shows an improvement in bones relationship with reduced ANB angles and OVJ measurements. The control group otherwise did not show any important changes in maxillo-mandibular discrepancies. The airway size increased in either group in most cases. No significant differences between the treated and control groups were detected for airway size neither in the upper, middle, nor lower level at the T1-T2 interval. CONCLUSION: The upper airway values did not show any significant discrepancies between the two groups during the observation period. CLINICAL SIGNIFICANCE: Functional devices were effective in solving class II relationships, but there is no evidence of successful breathing disorders prevention by using mandibular activators, probably due to the stability of airway tissues reached in pubertal age in both groups.


Assuntos
Má Oclusão de Angle Classe II , Faringe , Cefalometria , Humanos , Má Oclusão de Angle Classe II/diagnóstico por imagem , Má Oclusão de Angle Classe II/terapia , Mandíbula/diagnóstico por imagem , Estudos Retrospectivos
10.
BMC Surg ; 20(1): 222, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008379

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) has been declared a global pandemic by the World Health Organization. Patients with cancer are more likely to incur poor clinical outcomes. Due to the prevailing pandemic, we propose some surgical strategies for gastric cancer patients. METHODS: The 'COVID-19' period was defined as occurring between 2020 and 01-20 and 2020-03-20. The enrolled patients were divided into two groups, pre-COVID-19 group (PCG) and COVID-19 group (CG). A total of 109 patients with gastric cancer were enrolled in this study. RESULTS: The waiting time before admission increased by 4 days in the CG (PCG: 4.5 [IQR: 2, 7.8] vs. CG: 8.0 [IQR: 2,20]; p = 0.006). More patients had performed chest CT scans besides abdominal CT before admission during the COVID-19 period (PCG: 22 [32%] vs. CG: 30 [73%], p = 0.001). After admission during the COVID period, the waiting time before surgery was longer (PCG: 3[IQR: 2,5] vs. CG: 7[IQR: 5,9]; p < 0.001), more laparoscopic surgeries were performed (PCG: 51[75%] vs. CG: 38[92%], p = 0.021), and hospital stay period after surgery was longer (7[IQR: 6,8] vs.9[IQR:7,11]; p < 0.001). In addition, the total cost of hospitalization increased during this period, (PCG: 9.22[IQR:7.82,10.97] vs. CG: 10.42[IQR:8.99,12.57]; p = 0.006). CONCLUSION: This study provides an opportunity for our surgical colleagues to reflect on their own services and any contingency plans they may have to tackle the COVID-19 crisis.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Laparoscopia/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Neoplasias Gástricas/cirurgia , Adulto , Idoso , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Seleção de Pacientes , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Padrões de Prática Médica , Utilização de Procedimentos e Técnicas , Estudos Retrospectivos
11.
J Orthop Surg Res ; 15(1): 452, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008440

RESUMO

BACKGROUND: A large number of cases of pneumonia caused by novel ß-coronavirus emerged in Hubei Province, China, at the end of 2019 and demonstrated great potential for transmission. At present, known independent risk factors include age, diabetes, and other chronic diseases, which may be similar to the patients with chronic wound; thus, we try to explore the clinical characteristics, prognostic factors, and management recommendation of patients with chronic infective wounds during the COVID-19 epidemic period. METHODS: In this single-center, retrospective observational study, we included all cases with chronic infective wounds that came to our hospital between the full outbreak of the COVID-19 in China (January 23, 2020) and the latest date prior to posting (20 April 2020). Demographic data, comorbidities, laboratory and imaging findings, consultation history, and clinical outcomes (lesion cured, uncontrolled, amputated, etc. as of May 10, 2020) were collected for all individuals. Patients were subdivided into gangrene, traumatic infection, and other types of soft tissue infection wound (including bedsores, gout ruptures, stab wounds, and so on) according to the causes of wound, and their disease-related information were compared group by group. RESULTS: Among the total 81 patients with chronic infective wounds, 60% were male, with a mean age of 60.8 years (SD 18.6), including 38 (47%) patients with traumatic infection, 29 (36%) gangrene cases, and 14 (17%) other soft tissue infection wounds. Common comorbidities are hypertension (32%), diabetes (32%), cardiovascular disease (24%), and kidney injury (12%), and the patients with gangrenes have the most comorbidities. As of May 10, 2020, there were 78 patients discharged, and their average stay time is 15.8 days (SD 14.2), while people still at the hospital is 39.7 days (SD 8.7) much longer than the discharged and also has more comorbidities. But there is no significant difference in the hospitalization time of three types of wounds. And fortunately, none of all the patients were infected by coronavirus. CONCLUSION: The majority of patients with chronic wounds are severely ill with high risk of infection and poor prognosis; therefore, management of patients with chronic wounds should be improved.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Infecção dos Ferimentos/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , China/epidemiologia , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Estudos Retrospectivos
13.
Rev Bras Epidemiol ; 23: e200091, 2020.
Artigo em Português, Inglês | MEDLINE | ID: mdl-33027433

RESUMO

OBJECTIVE: To analyze the association between the transmission potential of SARS-CoV-2 and the decisions made by the municipal government of Florianópolis (Brazil) regarding social distancing. METHODS: We analyzed new cases of COVID-19 identified in Florianópolis residents between February 1 and July 14, 2020, using a nowcasting approach. Decrees related to COVID-19 published in the Official Gazette of the Municipality between February 1 and July 14, 2020 were also analyzed. Based on the actions proposed in the decrees, whether they loosened social distancing measures, or increased or maintained existing restrictions, was analyzed, thus creating a Social Distancing Index. Time-dependent reproduction numbers (Rt) for a period of 14 days prior to each decree were calculated. A matrix was constructed associating the classification of each decree and the Rt values, analyzing the consonance or dissonance between the potential dissemination of SARS-CoV-2 and the actions of the decrees. RESULTS: A total of 5,374 cases of COVID-19 and 26 decrees were analyzed. Nine decrees increased social distancing measures, nine maintained them, and eight loosened them. Of the 26 actions, 9 were consonant and 17 dissonant with the tendency indicated by the Rt. Dissonance was observed in all of the decrees that maintained the distance measures or loosened them. The fastest expansion in the number of new cases and the greatest amount of dissonant decrees was found in the last two months analyzed. CONCLUSION: There was an important divergence between municipal measures of social distancing with epidemiological indicators at the time of each political decision.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Tomada de Decisões , Governo Local , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Brasil/epidemiologia , Humanos , Estudos Retrospectivos , Distância Social
14.
Rev Assoc Med Bras (1992) ; 66(9): 1241-1246, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33027452

RESUMO

OBJECTIVE: To investigate the prevalence of hypophosphatemia as a marker of refeeding syndrome (RFS) before and after the start of nutritional therapy (NT) in critically ill patients. METHODS: Retrospective cohort study including 917 adult patients admitted at the intensive care unit (ICU) of a tertiary hospital in Cuiabá-MT/Brasil. We assessed the frequency of hypophosphatemia (phosphorus <2.5mg/dl) as a risk marker for RFS. Serum phosphorus levels were measured and compared at admission (P1) and after the start of NT (P2). RESULTS: We observed a significant increase (36.3%) of hypophosphatemia and, consequently, a greater risk of RFS from P1 to P2 (25.6 vs 34.9%; p<0.001). After the start of NT, malnourished patients had a greater fall of serum phosphorus. Patients receiving NT had an approximately 1.5 times greater risk of developing RFS (OR= 1.44 95%CI 1.10-1,89; p= 0.01) when compared to those who received an oral diet. Parenteral nutrition was more associated with hypophosphatemia than either enteral nutrition (p=0,001) or parenteral nutrition supplemented with enteral nutrition (p=0,002). CONCLUSION: The frequency of critically ill patients with hypophosphatemia and at risk for RFS on admission is high and this risk increases after the start of NT, especially in malnourished patients and those receiving parenteral nutrition.


Assuntos
Hipofosfatemia , Síndrome da Realimentação , Brasil , Estado Terminal , Humanos , Estudos Retrospectivos
15.
Rev Assoc Med Bras (1992) ; 66(9): 1252-1257, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33027454

RESUMO

OBJECTIVE: To describe the characteristics of patients treated at a level III surgical Neonatal Intensive Care Unit outside of a maternity service and analyze possible risk factors for mortality in this population. METHODS: A retrospective cohort study evaluating patients admitted to a level III surgical Neonatal Intensive Care Unit from June/2015 to November/2017. Univariate analysis was performed by the Chi-square test and T-student test or Mann-Whitney test. Multivariate analysis by logistic regression was performed including in the model the variables with a P-value <0.2 in univariate analysis. Kaplan-Meier curve and Log-Rank test were performed using the variables that were statistically associated with death in the multivariate analysis. A significance level of a=5% and an error B=80% were adopted. RESULTS: During this period, 246 patients were admitted to this service. 58 (23.8%) patients died, with a mean time until death of 18 days. Half of the patients had a clinical diagnosis of sepsis (50.6%), blood culture was positive in 25.2%, and gram-positive bacteria (48.4%) were the main pathogens isolated. The variables that remained in the final model after multivariate analysis were diagnosis of congenital heart disease (OR = 4.5; p = 0.016), clinical diagnosis of sepsis (OR = 8.1; p = 0.000), and isolation of gram-positive bacteria in blood culture (OR = 3.9; p = 0.006). CONCLUSION: The level III surgical Neonatal Intensive Care Unit outside of a maternity service has a different profile of morbidity and mortality, and death was associated with the diagnosis of congenital heart disease, the clinical diagnosis of sepsis, and the isolation of gram-positive bacteria in the blood culture.


Assuntos
Unidades de Terapia Intensiva Neonatal , Feminino , Humanos , Recém-Nascido , Morbidade , Gravidez , Estudos Retrospectivos , Fatores de Risco , Sepse
16.
Rev Med Liege ; 75(10): 676-681, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-33030845

RESUMO

In Wallonia, almost one fourth of cesarean sections are performed on nulliparous women with vertex nonanomalous singleton gestations who underwent induction of labor. The purpose of this study is to compare maternal and neonatal outcomes with elective induction of labor versus spontaneous onset of labor. Data for all deliveries at CHU de Liège over a two-year period were obtained. Women with vertex nonanomalous singleton gestations who delivered from 3900 to 40+6 weeks were selected. We tested the association of elective induction and operative vaginal delivery, cesarean section, post-partum hemorrhage, episiotomy and perineal lacerations, length of labor, length of stay, 1-min and 5-min APGAR inferior to 7 and admission to neonatal intensive care unit. Length of stay was significantly longer in all induced women. In nulliparous women, there was a 45 % probability of operative vaginal delivery or cesarean section delivery in those who underwent elective induction of labor. In light of these results, it seems that our policy of elective induction of labor in nulliparous women is causing unnecessary and potentially avoidable interventions.


Assuntos
Cesárea , Trabalho de Parto Induzido , Feminino , Humanos , Gravidez , Estudos Retrospectivos
17.
Rozhl Chir ; 99(8): 343-349, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33032438

RESUMO

INTRODUCTION: The study compares the results of open reduction using volar locking plates with ligamentotaxis by external fixation in fractures of distal radius type 2R3C according to AO classification. METHODS: A retrospective study evaluating the results of osteosynthesis in patients with distal radius fractures type 2R3C according to AO classification, operated until December 2018. The ORIF method with volar locking plates (LCP) was used in 54 patients, and closed reduction with ligamentotaxis using external fixation (EF) was used in 33 patients. The mean age of the patients was 46.7 years in the LCP group and 59.6 years in the EF group. All were evaluated for their X-ray and functional outcomes and according to the Green and OBrien score at 6 and 12 months after surgery.  Results: According to X-rays at 12 months in the LCP group, the mean sagittal tilt was 10.13°, the mean radial inclination was 23.89°, and the mean radial length was 11.84 mm. In the EF group, the mean sagittal tilt was 6.32°, the mean radial inclination was 24.78°, and the mean radial length was 9.89 mm. According to the Green and OBrien score, we recorded a mean score of 84.44 points in the LCP group at 12 month; we achieved good and excellent results in 83.33% of the patients and no poor result was observed. In the EF group the final mean score was 77.27; good and excellent results were achieved in 45.46% of the patients and a poor result in one patient. CONCLUSION: Based on the results in our group of patients, the internal type osteosynthesis using LCP implants can be recommended as a first-choice technique in the treatment of 2R3C fractures according to AO classification.


Assuntos
Fraturas do Rádio , Rádio (Anatomia) , Placas Ósseas , Fixação de Fratura , Humanos , Pessoa de Meia-Idade , Rádio (Anatomia)/diagnóstico por imagem , Rádio (Anatomia)/cirurgia , Fraturas do Rádio/diagnóstico por imagem , Fraturas do Rádio/cirurgia , Estudos Retrospectivos
18.
Stomatologiia (Mosk) ; 99(5): 50-57, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33034177

RESUMO

THE AIM OF THE STUDY: Was to presents the first clinical medium-term (18 months) results of implant-supported rehabilitation using this method in Russia, with the special attention paid to the assessment of the patient's quality of life on the GOHAI scale. MATERIALS AND METHODS: The authors performed a clinical and paraclinical examination of 29 patients (20 women and 9 men). The age of the patients ranged from 47 to 88 (average value - 65.45±9.7). We performed a retrospective analysis of all patients operated from June 2017 till March 2019. The patients filled in GOHAI questionnaires about their state of health and quality of life (before treatment and 6 weeks post-surgery). Patients with one or more anterior teeth present as well as fully edentulous mandibles were included in the study. The antagonist teeth could be presented as complete dentures, natural teeth, or implant-supported fixed restorations. All patients received three Trefoil implants (Nobel Biocare AB) inserted with a torque of at least 35 Ncm. The Trefoil bar (Nobel Biocare AB) was used as the framework of the Trefoil bioengineering structure. Statistical processing of the results was performed using the SPSS 23 software. The t-test for dependent samples was used to compare the results of GOHAI surveys before and after the operation and the following statistical hypotheses were suggested: H0 - the results of the GOHAI survey before the operation do not differ from the results of the GOHAI survey after the operation; H1 - GOHAI pre-op survey results are different from GOHAI post-op survey results. A comparison was made between the GOHAI results before and after surgery in male and female patients using the t-test for independent samples. RESULTS: 29 patients included in this (20 females and 9 males) with the mean age of 65 (range:47-88). The average time of operation (surgical operation, prosthetic stage including dental lab work) the Trefoil technique was 6.18 ± 0.87 hours. With the presence of teeth in the mandible, the operation took longer by an average of 45 minutes. Patients were followed for 15±6 months. No chipping of artificial teeth or fractures of the veneering was observed. The survival rate of restorations was 100%. The implant survival rate was 98.85%. The results of the GOHAI survey after surgery show a significant difference from the results of the pre-op survey. If we analyze the average values for the sample, it can be argued that the average result for the GOHAI survey before the operation (29.86) is significantly lower than the average one for the GOHAI survey after the operation (54.93). CONCLUSION: Preliminary medium-term results of the Trefoil concept for implant-supported rehabilitation of the mandible indicate high patient satisfaction results after 6-18 months of follow-up. It requires a further comprehensive study to obtain data with more patients and over a longer follow-up period.


Assuntos
Lotus , Feminino , Humanos , Masculino , Saúde Bucal , Qualidade de Vida , Estudos Retrospectivos , Federação Russa
19.
Artigo em Chinês | MEDLINE | ID: mdl-33040496

RESUMO

Objective:Analyze the relationship between the change of mucosal wave and the infiltrating level of early laryngeal carcinoma so as to guide the cordectomy. Method:Retrospective research on patients of 1a stage without anterior commissure invasion who received simple CO2 laser therapy because of primary glottic laryngeal squamous cell carcinoma. Result:Records of 320 patients including 22 patients who have slightly reduced according to the mucosal wave prompts before operation, 49 patients mucosal wave moderately reduced, 151 patients mucosal wave severely reduced, and 98 patients have mucosal wave disappeared according to stroboscopic assessment. Post-pathological evidence shows that 16 patients had their tumor infiltration into the epithelial layer, of which, 15 received the Ⅲ type laser surgery, 1 patient received the Ⅳ type laser surgery; 189 patients had their tumor infiltration into the lamina propria, of which, 148 received the Ⅲ type laser surgery, 41 received the Ⅳ type laser surgery; and 115 patients had their tumor infiltration into the vocal cord muscle layer, of which, 77 received the Ⅲ type laser surgery, 38 received the Ⅳ type laser surgery. Analyzed according to the Kaplan-Meier method, it shows that their five-year overall survival rate was 94.0%, the five-year disease-specific survival rate was 98.4%; and five-year local-region control rate was 91.2%. Change of the mucosal wave and the tumor infiltrating level have significant correlation; patients whose tumor infiltration had reached the lamina propria received the Ⅲ and Ⅳ type laser surgical treatment, their five-year overall survival rate and their five-year local-region area control rate have no obvious difference; patients whose tumor infiltration have reached the muscular layer received the Ⅲ and Ⅳ type laser surgical treatment, their five-year overall survival rate and their five-year local-region area control rate have no significant difference. Conclusion:This research shows that, change of the mucosal wave can, to a certain extent, prompt the tumor infiltration degree and guide in operation; for patients who are suspected of laryngeal carcinoma, when mucosal wave before operation prompts moderate-sever reduction or disappearance, to ensure bottom incisal margin clean, it should be cut at least to the muscular layer; for laryngeal cancer patients whose infiltrating mucosal wave disappears, it prompts that the tumor may have infiltrated to the muscular layer, and the Ⅲ and Ⅳ type laser surgery will have no significant prognostic influence.


Assuntos
Neoplasias Laríngeas , Terapia a Laser , Glote , Humanos , Neoplasias Laríngeas/cirurgia , Membrana Mucosa , Estudos Retrospectivos
20.
Artigo em Chinês | MEDLINE | ID: mdl-33040497

RESUMO

Objective:To explore the correlation factors and prognosis of local recurrence of laryngeal squamous cell carcinoma. Method:The clinical data of 69 patients with local recurrence of laryngeal squamous cell carcinoma were analyzed retrospectively. The survival curve was analyzed by Kaplan-Meier method, and the survival rate was compared by chi-square test and log rank test, Cox risk regression model was used to analyze multivariate survival. Result:Patients with local recurrence of laryngeal cancer had DFS and OS at 3 years of 17.4% and 63.8%, at 5 years of 4.3% and 40.6%, respectively. The invasion of the thyroid cartilage plate is significantly related to the prognosis of the patient, and the degree of squamous cell carcinoma differentiation is an independent factor influencing the prognosis, patients with non-invasive thyroid cartilage plate and high differentiated squamous cell carcinoma have better prognosis. Conclusion:Local recurrence of laryngeal carcinoma is common among patients with moderately or poorly differentiated squamous cell carcinoma, invasion of the thyroid cartilage plate, and positive or insufficient resection margins. And the prognosis of above patients is still poor after receiving salvage surgery; comprehensive treatment and closer follow-up should be paid to these patients.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Laríngeas , Humanos , Recidiva Local de Neoplasia/epidemiologia , Prognóstico , Estudos Retrospectivos
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