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4.
Emerg Infect Dis ; 27(4): 1234-1237, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33565961
5.
Rev. enferm. UERJ ; 28: e52825, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1146276

RESUMO

Objetivo: identificar os impactos na saúde mental de bombeiros relacionados ao estresse da exposição ocupacional. Método: trata-se de uma revisão integrativa da literatura nas bases de dados CINAHL (EBSCO), PsycINFO, MEDLINE®, LILACS, Web of Science, Scopus e SCIELO. Para a estratégia de busca utilizou-se os descritores: "Occupational Stress", "Firefighters", "Occupational Exposure". Como critérios de inclusão estabeleceu-se: artigos originais; entre os anos de 2009 e 2019; disponíveis completos; estudos transversais; nos idiomas português, inglês e/ou espanhol; e cuja população de estudo incluíssem bombeiros. Resultados: nessa revisão foram analisados 11 artigos. Evidenciou-se que a exposição de bombeiros impactou o desencadeamento de sintomas de depressão e transtorno de estresse pós-traumático. Conclusão: as evidências deste estudo demonstraram que a exposição ocupacional de bombeiros interfere no seu padrão de saúde mental causando estresse por meio do sofrimento psíquico. Este estudo alerta para a necessidade de intervenção e promoção à saúde do bombeiro.


Objective: to identify mental health impacts of occupational exposure-related stress among firefighters. Method: this integrative literature review searched the CINAHL (EBSCO), PsycINFO, MEDLINE®, LILACS, Web of Science, Scopus and SCIELO databases, suing the descriptors: "Occupational Stress", "Firefighters", "Occupational Exposure". The inclusion criteria were: original articles; between the years 2009 and 2019; full text available; cross-sectional studies; in Portuguese, English and/or Spanish; and whose study population included firefighters. Results: 11 articles were analyzed. Firefighters' exposure was found to impact the triggering of depressive symptoms and post-traumatic stress disorder. Conclusion: the evidence in this study demonstrated that firefighters' occupational exposure interferes with their mental health patterns, causing stress through psychological suffering. This study warns of the need for intervention and promotion of firefighters' health.


Objetivo: identificar los impactos en la salud mental del estrés relacionado con la exposición ocupacional entre los bomberos. Método: esta revisión integradora de la literatura buscó en las bases de datos CINAHL (EBSCO), PsycINFO, MEDLINE®, LILACS, Web of Science, Scopus y SCIELO, demandando los descriptores: "Estrés ocupacional", "Bomberos", "Exposición ocupacional". Los criterios de inclusión fueron: artículos originales; entre los años 2009 y 2019; Texto completo disponible; estudios transversales; en portugués, inglés y / o español; y cuya población de estudio incluyó bomberos. Resultados: se analizaron 11 artículos. Se descubrió que la exposición de los bomberos afecta la activación de síntomas depresivos y el trastorno de estrés postraumático. Conclusión: la evidencia de este estudio demostró que la exposición ocupacional de los bomberos interfiere con sus patrones de salud mental, provocando estrés a través del sufrimiento psicológico. Este estudio advierte de la necesidad de intervención y promoción de la salud de los bomberos.


Assuntos
Humanos , Masculino , Feminino , Estresse Psicológico , Bombeiros/psicologia , Estresse Ocupacional , Transtornos de Estresse Pós-Traumáticos , Condições de Trabalho , Riscos Ocupacionais , Fatores Desencadeantes , Saúde do Trabalhador , Depressão
6.
Mymensingh Med J ; 29(4): 800-806, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33116080

RESUMO

Hepatic encephalopathy (HE) is a neuro-psychiatric manifestation of chronic liver disease causing significant morbidity and mortality worldwide. Though the exact mechanism is unknown but it is well accepted that various precipitating factors are involved in hepatic encephalopathy. Aim of the study was explore the precipitating factors of chronic hepatic encephalopathy. This cross sectional descriptive study was conducted in the Department of Medicine and Department of Hepatology, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during the period from April 2016 to October 2016. One hundred patients with hepatic encephalopathy fulfilling the inclusion and exclusion criteria were enrolled. Inclusion criteria were designed for all diagnosed cases of hepatic encephalopathy associated with cirrhosis of liver aged 18 years or above irrespective of sex. Patients with acute fulminant hepatitis and non-cirrhotic hepatic encephalopathy were excluded. The result of the study was mean age of hepatic encephalopathy was 52.81±8.15 years and 94.0% patients were above 40 years. Male (66.0%) were predominant over female (34.0%). HBsAg and Anti HCV were positive in 49.0% and 11.0% patients respectively. Stage of hepatic encephalopathy was stage-I in 8.0%, stage-II in 37.0%, stage-III in 39.0% and stage-IV in 16.0% patients. Changes of biochemical parameters were low haemoglobin level (70.0%), raised total count of leukocyte (25.0%), low platelet count (68.0%), low serum albumin (98.0%) raised prothrombin time (60.0%), low serum sodium (34.0%) and low serum potassium (63.0%). The recoded precipitating factors were gastrointestinal bleeding (14.0%), constipation (37.0%), hyponatremia (34.0%), hypokalemia (28.0%) infections (20.0%), use of diruretics (8.0%), use of sedatives (4.0%) and excess intake of protein (6.0%). While precipitating factor was absent in 11.0% of cases. In conclusion there are different factors which play a key role in precipitating hepatic encephalopathy but electrolytes imbalance, constipation, infections, Upper GI bleed, diuretics are the most common precipitating factors.


Assuntos
Encefalopatia Hepática , Adolescente , Adulto , Bangladesh , Estudos Transversais , Feminino , Encefalopatia Hepática/epidemiologia , Encefalopatia Hepática/etiologia , Humanos , Cirrose Hepática , Masculino , Pessoa de Meia-Idade , Fatores Desencadeantes
7.
Rev. chil. enferm. respir ; 36(3): 176-201, set. 2020. tab, graf
Artigo em Espanhol | LILACS | ID: biblio-1138552

RESUMO

El asma bronquial es la enfermedad crónica más frecuente en la infancia. Sin embargo, en Chile existe un importante subdiagnóstico. Es fundamental estar atentos a los síntomas y signos que nos hacen sospechar el diagnóstico para iniciar un tratamiento oportuno, que asegure un buen control de la enfermedad. Debemos sospechar asma en todo escolar que presente cuadros repetidos de obstrucción bronquial. El diagnóstico debe confirmarse con pruebas de función pulmonar que demuestren obstrucción variable al flujo aéreo y respuesta broncodilatadora positiva. El tratamiento se basa en dos pilares fundamentales: la educación y el tratamiento farmacológico. Las actividades educativas deben incluir contenidos acerca de la enfermedad y su tratamiento, se debe monitorizar constantemente la adherencia al tratamiento de mantención, enseñar la técnica inhalatoria correcta y revisar en cada control, entregar un plan de acción escrito personalizado frente al inicio de una crisis y realizar controles médicos periódicos. Con respecto al tratamiento farmacológico, el estándar de oro es el uso de corticoides inhalados permanentes, en la mínima dosis posible que logre el control de la enfermedad. El objetivo del tratamiento es la supresión de los síntomas diarios y de las crisis. El tratamiento se irá incrementando en la medida que no haya una respuesta adecuada, pero antes de aquello se debe evaluar la adherencia al tratamiento de mantención, la técnica inhalatoria, presencia de comorbilidades asociadas y exposición ambiental. En el paciente leve, que esté sin tratamiento permanente, el rescate debe realizarse con broncodilatadores asociados siempre a un corticoide inhalado. Este consenso es una guía de apoyo para mejorar el diagnóstico oportuno, tratamiento y control del asma en el escolar.


Bronchial asthma is the most prevalent chronic condition among children, however, in Chile, it is underdiagnosed. This may be due to medical professionals failing to recognize the disease. It is essential to be aware of the symptoms and signs that are suggestive of the disease in order to begin an appropriate treatment to achieve disease control. Asthma must be suspected in school age children who present repeated episodes of bronchial obstruction. The diagnosis should be confirmed with lung function tests that demonstrate variable airflow obstruction with a positive bronchodilator response. Treatment is based on two fundamental pillars: education and pharmacological treatment. Educational activities must include: information about the disease and its treatment, regular monitoring of treatment adherence, teaching and reviewing the correct inhalation technique at every checkup, developing a personalized written action plan and scheduling regular follow-up appointments. The gold standard for treatment is maintenance inhaled corticosteroids, in the lowest possible dose that enables disease control. The goal of the treatment is to eliminate daily symptoms and asthma crisis. Therapy should be increased if control is not achieved, but before starting it, adherence to maintenance treatment, inhalation technique, presence of associated comorbidities and environmental exposure should be evaluated. In the mild patient, who is not receiving maintenance therapy, rescue treatment should be done with bronchodilators, always associated with inhaled corticosteroids. This consensus is a guide to improve the diagnosis, treatment and control of asthma in schoolchildren


Assuntos
Humanos , Criança , Asma/diagnóstico , Asma/terapia , Oxigenoterapia , Testes de Função Respiratória , Asma/classificação , Asma/tratamento farmacológico , Vitamina D/sangue , Índice de Gravidade de Doença , Nebulizadores e Vaporizadores , Radiografia Torácica , Fatores Desencadeantes , Chile , Consenso , Diagnóstico Diferencial
9.
ABCS health sci ; 45: e020015, 02 jun 2020. tab
Artigo em Inglês | LILACS | ID: biblio-1123703

RESUMO

INTRODUCTION: Coronary artery disease is the largest cause of mortality in the world. The main risk factors for its development include systemic arterial hypertension and type 2 diabetes mellitus. OBJECTIVE: To search for predictors of the development of plaques and obstructions in coronary arteries and to determine whether the exercise test is a reliable pretest for coronary angiotomography. METHODS: 883 computed tomography reports of coronaries were analyzed. Sociodemographic information, health conditions and results of the exercise test from patients were collected, along with calcium score, percentile and number of arterial segments with significant obstruction. The data were analyzed using descriptive and inferential statistics. Significance was considered for p<0.05. RESULTS: It observed that the statistically significant predictors to the calcium score were male, being over 60 years old, having type 2 diabetes mellitus and systemic arterial hypertension. There was no relationship with high BMI and coronary obstruction. Regarding the exercise test, it was possible to observe that the majority of individuals who were positive in the exercise test, did not have a positive calcium score or significant coronary obstructions. CONCLUSION: The predictors for the development of coronary plaques and obstructions were male, aged ≥60 years, having type 2 diabetes mellitus and systemic arterial hypertension.


INTRODUÇÃO: A doença arterial coronariana representa a maior causa de mortalidade no mundo, sendo que os principais fatores de risco para o seu desenvolvimento incluem a hipertensão arterial sistêmica e a diabetes mellitus tipo 2. OBJETIVO: Detectar os preditores para o desenvolvimento de placas e obstruções coronarianas detectadas através da tomografia computadorizada de artérias coronárias além de determinar se o teste de esforço é um pré-teste fidedigno para a realização angiotomografia coronariana. MÉTODOS: Foi realizada análise de 883 laudos de exames de TC de coronárias e coletados dados sociodemográficos, de saúde e o resultado do teste de esforço, juntamente com escore de cálcio, percentil e quantidade de segmentos arteriais com obstruções significativas. Os dados foram analisados pela estatística descritiva e inferencial (p<0,05). RESULTADOS: Foi possível observar que os preditores com valores estatisticamente significantes em relação ao escore de cálcio foi ser do sexo masculino, possuir idade acima de 60 anos, portar diabetes mellitus tipo 2 e hipertensão arterial sistêmica, não houve relação entre IMC elevado, que sugere sobrepeso, e obstrução coronariana. Em relação ao teste de esforço foi possível observar que a maioria dos indivíduos que apresentaram positividade no teste de esforço, não apresentavam escore de cálcio positivo ou obstruções coronarianas significativas. CONCLUSÃO: Os preditores para o desenvolvimento de placas e obstruções coronarianas foi pertencer ao sexo masculino, apresentar idade ≥60 anos, ser portadores de diabetes mellitus tipo 2 e hipertensão arterial sistêmica.


Assuntos
Humanos , Masculino , Feminino , Doença da Artéria Coronariana , Vasos Coronários/diagnóstico por imagem , Teste de Esforço , Angiografia por Tomografia Computadorizada , Fatores Desencadeantes , Estudos Transversais , Estilo de Vida
10.
Vet Rec ; 187(4): 152, 2020 08 22.
Artigo em Inglês | MEDLINE | ID: mdl-32444506

RESUMO

BACKGROUND: Canine idiopathic epilepsy (IE) is characterised by recurrent seizure activity, which can appear unpredictable and uncontrollable. The purpose of this study was to investigate the potential for seizure prediction in dogs by exploring owner-perceived seizure prediction abilities and identifying owner-reported prodromal changes (long-term changes in disposition that indicate forthcoming seizures) and seizure triggers (stimuli that precipitate seizures) in dogs with IE. METHODS: This is an online, international, cross-sectional survey of 229 owners of dogs diagnosed with IE, meeting the International Veterinary Epilepsy Task Force tier I diagnostic criteria. RESULTS: Over half (59.6 per cent) of owners believed they were able to predict an upcoming seizure in their dog, of whom nearly half (45.5 per cent) were able to do so at least 30 minutes before the seizure commenced. The most common 'seizure predictors' were preseizure behavioural changes including increased clinginess (25.4 per cent), restlessness (23.1 per cent) and fearful behaviour (19.4 per cent). Nearly two-thirds of owners reported prodromal changes (64.9 per cent), most commonly restlessness (29.2 per cent), and nearly half (43.1 per cent) reported seizure triggers, most commonly stress (39.1 per cent). CONCLUSIONS: The relatively high prevalence of owner-reported prodromal changes and seizure triggers shows promise for utilising these methods to aid seizure prediction in dogs, which could open a window of time for pre-emptive, individualised drug interventions to abort impending seizure activity.


Assuntos
Doenças do Cão , Epilepsia/veterinária , Convulsões/veterinária , Animais , Estudos Transversais , Doenças do Cão/etiologia , Cães , Feminino , Previsões , Humanos , Masculino , Pessoa de Meia-Idade , Propriedade , Fatores Desencadeantes , Convulsões/etiologia , Inquéritos e Questionários
11.
J Trauma Acute Care Surg ; 88(6): 847-854, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32118818

RESUMO

BACKGROUND: Platelet transfusion has been utilized to reverse platelet dysfunction in patients on preinjury antiplatelets who have sustained a traumatic intracranial hemorrhage (tICH); however, there is little evidence to substantiate this practice. The objective of this study was to perform a systematic review on the impact of platelet transfusion on survival, hemorrhage progression and need for neurosurgical intervention in patients with tICH on prehospital antiplatelet medication. METHODS: Controlled, observational and randomized, prospective and retrospective studies describing tICH, preinjury antiplatelet use, and platelet transfusion reported in PubMed, Embase, Cochrane Reviews, Cochrane Trials and Cochrane DARE databases between January 1987 and March 2019 were included. Investigations of concomitant anticoagulant use were excluded. Risk of bias was assessed using the Newcastle-Ottawa scale. We calculated pooled estimates of relative effect of platelet transfusion on the risk of death, hemorrhage progression and need for neurosurgical intervention using the methods of Dersimonian-Laird random-effects meta-analysis. Sensitivity analysis established whether study size contributed to heterogeneity. Subgroup analyses determined whether antiplatelet type, additional blood products/reversal agents, or platelet function assays impacted effect size using meta-regression. RESULTS: Twelve of 18,609 screened references were applicable to our questions and were qualitatively and quantitatively analyzed. We found no association between platelet transfusion and the risk of death in patients with tICH taking prehospital antiplatelets (odds ratio [OR], 1.29; 95% confidence interval [CI], 0.76-2.18; p = 0.346; I = 32.5%). There was no significant reduction in hemorrhage progression (OR, 0.88; 95% CI, 0.34-2.28; p = 0.788; I = 78.1%). There was no significant reduction in the need for neurosurgical intervention (OR, 1.00; 95% CI, 0.53-1.90, p = 0.996; I = 59.1%; p = 0.032). CONCLUSION: Current evidence does not support the use of platelet transfusion in patients with tICH on prehospital antiplatelets, highlighting the need for a prospective evaluation of this practice. LEVEL OF EVIDENCE: Systematic Reviews and Meta-Analyses, Level III.


Assuntos
Doenças Cardiovasculares/tratamento farmacológico , Hemorragia Intracraniana Traumática/terapia , Inibidores da Agregação Plaquetária/efeitos adversos , Transfusão de Plaquetas/normas , Guias de Prática Clínica como Assunto , Aspirina/efeitos adversos , Doenças Cardiovasculares/prevenção & controle , Clopidogrel/efeitos adversos , Progressão da Doença , Humanos , Hemorragia Intracraniana Traumática/sangue , Hemorragia Intracraniana Traumática/mortalidade , Fatores Desencadeantes , Resultado do Tratamento
14.
PLoS One ; 14(12): e0226402, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31841545

RESUMO

Recent advances on the environmental determinants of Kawasaki Disease have pointed to the important role of the atmospheric transport of a still unknown agent potentially triggering the disease. The hypothesis arose from an innovative methodology combining expertise in climate dynamics, the analysis of ocean and atmosphere data, the use of dispersion models and the search for biological agents in air samples. The approach offered a new perspective to reveal the identity of the potential trigger, but at the same time, it increased the level of complexity, which could potentially lead to the misinterpretation of the mechanisms. Some years after it was originally formulated, we here provide a brief clarification on the approach and limits of the methodology in order to prevent an eventual misuse of our research ideas and theory, so that further research can better focus on the knowledge gaps that still remain open.


Assuntos
Clima , Meio Ambiente , Síndrome de Linfonodos Mucocutâneos/etiologia , Atmosfera , Canadá/epidemiologia , Monitoramento Ambiental , Geografia , Humanos , Incidência , Japão/epidemiologia , Síndrome de Linfonodos Mucocutâneos/epidemiologia , Nova Zelândia/epidemiologia , Fatores Desencadeantes , Fatores de Risco , Estações do Ano , Estados Unidos/epidemiologia , Vento
15.
BMJ Case Rep ; 12(12)2019 Dec 05.
Artigo em Inglês | MEDLINE | ID: mdl-31811105

RESUMO

We describe the case of a 25-year-old parturient who presented sudden onset and short-lived severe headache caused by reversible cerebral vasoconstriction syndrome (RCVS) during an emergency caesarean section. The syndrome was triggered by phenylephrine administered intravenously to correct arterial hypotension following spinal anaesthesia. RCVS is a clinical and radiological syndrome attributed to transient disturbance in the control of cerebral arterial tone resulting in vasospasms. The syndrome can be precipitated by several triggers, including vasoactive drugs, often used during spinal anaesthesia, illicit drugs, pregnancy and postpartum state. Diagnosis and management can be challenging during pregnancy, peripartum or post partum, since many medications commonly used during these periods must be avoided to prevent triggering RCVS. The aim of this report is to raise the awareness, particularly for anaesthesiologists and obstetricians, of this rare and potentially serious syndrome. We discuss diagnosis, triggers, pathogenesis, clinical course and complications, as well as coordinated multidisciplinary management plans.


Assuntos
Transtornos Cerebrovasculares/diagnóstico , Hipertensão/diagnóstico , Complicações Intraoperatórias/diagnóstico , Fenilefrina/efeitos adversos , Vasoconstritores/efeitos adversos , Vasoespasmo Intracraniano/diagnóstico , Adulto , Raquianestesia/efeitos adversos , Transtornos Cerebrovasculares/induzido quimicamente , Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/diagnóstico por imagem , Cesárea , Diagnóstico Diferencial , Feminino , Cefaleia/etiologia , Humanos , Hipertensão/induzido quimicamente , Hipertensão/complicações , Hipertensão/diagnóstico por imagem , Complicações Intraoperatórias/induzido quimicamente , Fenilefrina/administração & dosagem , Fatores Desencadeantes , Gravidez , Vasoconstritores/administração & dosagem , Vasoespasmo Intracraniano/induzido quimicamente , Vasoespasmo Intracraniano/complicações , Vasoespasmo Intracraniano/diagnóstico por imagem
16.
Chiropr Man Therap ; 27: 58, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31827766

RESUMO

Background: The one-month prevalence of back pain in children and adolescents has been reported at 33, 28 and 48% at ages 9, 13 and 15 respectively. There are many suspected risk factors and triggers of back pain in young people. Objective: The purpose of this scoping review was to identify potential risk factors and potential triggers for back pain in young people. The purpose of part I was to identify potential risk factors for incident and episodic back pain in young people. Part II included all eligible studies with unclear or mixed types of back pain. Methods: Due to the vast number of studies on "risk factors" for back pain, a two-part scoping review of the literature was chosen as the best way to summarise the evidence. We adhered to the PRISMA-ScR guideline for scoping reviews. General potential risk factors and triggers for back pain in children and young adults (≤ 24 years) were included, incorporating physical, environmental, and/or physiological factors. A search was conducted using PubMed and Cochrane databases from inception to September 2018, limited to the English language. Within part I, and because of their importance, only the results of the studies that investigated risk factors of incident back pain and back pain episodes are presented. Results: The search identified 7356 articles, of which 91 articles were eligible for this scoping review. The majority of the eligible articles had an unclear definition of back pain (results presented in scoping review part II). There were 7 inception cohort studies included and 1 cohort study that met the criteria for part I. The most consistent risk factors for incident and episodic back pain are female sex and older age. Conclusion: Due to inconsistent ways of reporting on the type of back pain, no definitive risk factor for back pain has been identified. In general, females often report more symptoms, also for other diseases, and older age is not a useful risk factor as it merely indicates that the onset may not be in childhood. Clearly, the time has come to study the causes of back pain from different angles.


Assuntos
Dor nas Costas/epidemiologia , Saúde da Criança/estatística & dados numéricos , Estudos de Coortes , Humanos , Fatores Desencadeantes , Fatores de Risco , Adulto Jovem
17.
Chiropr Man Therap ; 27: 61, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31827768

RESUMO

Background: Back pain is a global problem in terms of disability and financially, with a large burden both to the individual and to society. Back pain was previously believed to be uncommon in children. However, there is a growing body of evidence that this is not the case. Objective: Part I of this scoping review studied risk factors of incident and episodic back pain. In this part II we aimed to identify all risk factors and triggers with unclear or mixed type back pain in young people and to identify any gaps in the literature. Methods: A scoping review design was selected to summarise the evidence, as there are many studies on "risk factors" for back pain. The scoping review followed the PRISMSA-ScR guidelines. We considered all studies that tested potential risk factors and triggers for thoracic and/or lumbar spine pain, in children, adolescents, and young adults (≤ 24 years). PubMed and Cochrane databases were searched from inception to September 2018, to identify relevant English language articles. The results regarding potential risk factors were separated into temporal precursors and bidirectional risk factors and the studies were classified by study design. Results: Our comprehensive search strategy identified 7356 articles, of which 83 articles were considered eligible for this review (part II). There were 53 cross-sectional studies and 30 cohort studies. Potential risk factors for back pain were: female sex, older age, later pubertal status, positive family history of back pain, increased growth, and a history of back pain, most of which are temporal precursor variables. There was limited research for the illness factors, spinal posture, and muscle endurance in the development of back pain. Conclusion: Many of the included studies approached risk factors in similar ways and found factors that were associated with back pain but were not obvious risk factors as causality was uncertain. Future research should be more rigorous and innovative in the way that risk factors are considered. This could be through statistical approaches including cumulative exposures, or longitudinal approaches including multi-trajectory methods. Additionally, data on proposed risk factors should be collected before the onset of back pain.


Assuntos
Dor nas Costas/epidemiologia , Dor nas Costas/etiologia , Saúde da Criança , Estudos de Coortes , Estudos Transversais , Humanos , Fatores Desencadeantes , Fatores de Risco , Adulto Jovem
18.
BMC Neurol ; 19(1): 281, 2019 Nov 12.
Artigo em Inglês | MEDLINE | ID: mdl-31718587

RESUMO

BACKGROUND: Myasthenia gravis associated takotsubo syndrome is a rare condition. This study aimed to explore its typical presentation, investigations and treatment through a systematic review of previously reported cases. METHODS: Databases and reference lists of the selected articles were searched for case reports on Myasthenia gravis associated takotsubo syndrome. CARE guidelines were used for the quality assessment of the selected articles. RESULTS: Sixteen cases were selected out of 580 search results. Western Pacific, American and European regions contributed to 88% of the cases. Females were most affected (81%). Features of both myasthenia gravis and takotsubo syndrome were the common clinical presentations. All cases had a myasthenic crisis. Half of the cases had no prior diagnosis of myasthenia gravis. Pyridostigmine and prednisolone were useful for myasthenia gravis while dobutamine was most commonly used for takotsubo syndrome. All cases survived except four (25%). CONCLUSIONS: Myasthenia gravis associated takotsubo syndrome via a myasthenic crisis is rare but life-threatening. Therefore, predisposition due to emotional and physical triggers needs to be avoided for its prevention. The rare entity should be suspected even in patients without a prior diagnosis of Myasthenia gravis.


Assuntos
Miastenia Gravis/complicações , Cardiomiopatia de Takotsubo/complicações , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Desencadeantes
19.
Arch Gynecol Obstet ; 300(6): 1613-1619, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31656970

RESUMO

PURPOSE: To investigate the precipitating factors of heart failure (HF) and to investigate the maternal and neonatal outcomes in pregnant women with HF. METHODS: We reviewed the medical records of pregnant women with HF who were treated at West China Second University Hospital between September 2012 and September 2017. We recorded baseline characteristics, onset and treatment of HF, comorbidities, modes of delivery, and maternal and fetal mortality and morbidity. Chi-square tests or Fisher's exact tests were used to explore the comorbidities in different subgroups. RESULTS: Seventy pregnant women with HF were identified. The most common pregnancy-specific conditions were severe preeclampsia (36/70, 51.43%) and multiple pregnancies (16/70, 22.86%). The most common nonpregnancy-specific conditions were lung infections (34/70, 48.57%) and cardiac problems (25/70, 35.71%). Sixty patients (85.71%) developed HF during pregnancy. Sixty-seven pregnancies (95.71%) ended in cesarean section. Three maternal deaths (4.29%) from HF were recorded. Of the 87 fetuses, three fetuses (3.45%) ended in miscarriages and stillbirth occurred in 5.75% of fetuses. The mean birth weight of a neonate was 2174.49 ± 609.57 (817-3430) g. There were eight neonatal deaths (8/79, 10.13%). The incidence of lung infection (P = 0.031) or cardiac problems (P = 0.044) differs between patients with NYHA classes II and patients with NYHA classes III/IV. The incidence of lung infection (P = 0.006) was also different in patients with prenatal HF and patients with postpartum HF. CONCLUSION: Peripartum HF is associated with high maternal and neonatal morbidity and mortality. Hypertensive disorders in pregnancy, lung infections, and cardiac problems are most common precipitating factors of HF in pregnancy.


Assuntos
Insuficiência Cardíaca/etiologia , Complicações na Gravidez/etiologia , Adolescente , Adulto , Peso ao Nascer , Feminino , Humanos , Recém-Nascido , Fatores Desencadeantes , Gravidez , Estudos Retrospectivos , Centros de Atenção Terciária , Fatores de Tempo , Adulto Jovem
20.
BMJ Case Rep ; 12(9)2019 Sep 20.
Artigo em Inglês | MEDLINE | ID: mdl-31540920

RESUMO

Takotsubo cardiomyopathy is a left ventricular dysfunction that typically occurs after sudden intense emotional or physical stress and mimics myocardial infarction. We describe a case of a 60-year-old woman that presented to the emergency department with chest pain after she attended a wedding and ate a large amount of wasabi, assuming it to be an avocado. To the best of our knowledge, this is the first report of takotsubo cardiomyopathy triggered by wasabi consumption.


Assuntos
Antagonistas Adrenérgicos beta/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Dor no Peito/induzido quimicamente , Antagonistas de Receptores de Mineralocorticoides/uso terapêutico , Cardiomiopatia de Takotsubo/induzido quimicamente , Wasabia/efeitos adversos , Dor no Peito/diagnóstico por imagem , Angiografia Coronária , Ecocardiografia , Feminino , Humanos , Pessoa de Meia-Idade , Fatores Desencadeantes , Cardiomiopatia de Takotsubo/diagnóstico por imagem , Cardiomiopatia de Takotsubo/tratamento farmacológico , Cardiomiopatia de Takotsubo/fisiopatologia , Resultado do Tratamento , Wasabia/química
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