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1.
Nefrología (Madrid) ; 40(6): 608-622, nov.-dic. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-197197

RESUMO

ANTECEDENTES Y OBJETIVO: Recientemente, se han desarrollado en España las Unidades de Enfermedad Renal Crónica Avanzada (UERCA) con el objetivo de ofrecer una mayor calidad de vida a los pacientes con ERCA, mejorar su supervivencia y disminuir la morbilidad en esta fase de la enfermedad. Al día de hoy, hay poca evidencia en la literatura española e internacional con respecto a la estructura y cómo conseguir estos objetivos en las UERCA. Desde el grupo de trabajo ERCA de la Sociedad Española de Nefrología (SEN) se impulsa este proyecto para mejorar la atención a los pacientes ERCA a través de la definición de estándares de calidad para el funcionamiento de las UERCA. MATERIAL Y MÉTODOS: Se conformó una propuesta inicial de estándares de calidad sobre el funcionamiento de las UERCA a través de la consulta de principales fuentes de referencias y el asesoramiento de un grupo de trabajo de expertos a través de reuniones presenciales y no presenciales. A partir de esta propuesta inicial de estándares, se diseñó y envío una encuesta vía correo electrónico a 121 especialistas de nefrología y profesionales de enfermería con experiencia en UERCA españolas para conocer entre otros, la idoneidad de cada estándar, es decir, su obligatoriedad o recomendación como estándar. Se permitió acceso a la encuesta entre el 16 de julio de 2018, hasta el 26 de septiembre de 2018. RESULTADOS: Participaron un total de 95 (78,5%) profesionales de los 121 que fueron invitados a participar. De éstos, 80 fueron especialistas en nefrología y 15 profesionales de enfermería, obteniéndose una variada representación de profesionales de la geografía española. Tras analizar las opiniones de estos participantes, los estándares quedaron definidos a un total de 68, 37 de ellos (54,4%) obligatorios y 31 de ellos (45,5%) recomendables. Además, se observó que el volumen de pacientes atendidos en las UERCA se sitúa usualmente por encima de los 100 pacientes, y que el criterio de derivación por regla general está por debajo de 25-29 mL/min/1,73 m2 de filtración glomerular. CONCLUSIONES: Este trabajo constituye una primera propuesta de estándares de calidad para el funcionamiento de una UERCA en España. La definición de estos estándares ha permitido establecer las bases para la estandarización de la organización de las UERCA, y trabajar posteriormente en la configuración de un manual de estándares para la acreditación de estas Unidades


BACKGROUND AND OBJECTIVE: Recently, the Advanced Chronic Kidney Disease Units (UERCA, in Spanish) have been developed in Spain to offer a better quality of life to patients with advanced chronic kidney disease (ACKD), improving their survival and reducing morbidity in this phase of the disease. Nowadays, there is not much evidence in the Spanish and international literature regarding the structure and how to achieve these objectives in the UERCA. From the ERCA working group of the Spanish Society of Nephrology (SEN), this project is promoted to improve care for ERCA patients through the definition of quality standards for the operation of the UERCA. MATERIAL AND METHODS: An initial proposal for quality standards concerning the operation of the UERCA was configured through consultation with the main sources of references and the advice of an expert working group through face-to-face and telematic meetings. Base on this initial proposal of standards, a survey was conducted and sent it via email to 121 nephrology specialist and nursing professionals with experience in Spanish UERCA to find out, among others, the suitability of each standards, that is, its mandatory nature or recommendation as standards. The access to the survey was allowed between July 16th, 2018, until September 26th, 2018. RESULTS: A total of 95 (78.5%) professionals participated out of the 121 who were invited to participate. Of these, 80 of the participants were nephrology specialists and 15 nursing professionals, obtaining a varied representation of professionals from the Spanish geography. After analyzing the opinions of these participants, the standards were defined to a total of 68, 37 of them (54.4%) mandatory and 31 of them (45.5%) recommended. Besides, it was observed that the volume of patients attended in the UERCA is usually above 100 patients, and the referral criteria is generally below 25-29 mL/min/1.73 m2 of glomerular filtration. CONCLUSIONS: This work constitutes a first proposal of quality standards for the operation of UERCA in Spain. The definition of these standards has made it possible to establish the bases for the standardization of the organization of UERCA, and to subsequently work on the configuration of a standards manual for the accreditation of ERCA Units


Assuntos
Humanos , Garantia da Qualidade dos Cuidados de Saúde/normas , Insuficiência Renal Crônica/terapia , Hospitais de Doenças Crônicas/normas , Segurança do Paciente/normas , Hospitais de Doenças Crônicas/estatística & dados numéricos , Inquéritos e Questionários , Espanha
2.
Geriatr Gerontol Int ; 20(7): 715-719, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32634849

RESUMO

AIM: To clarify the association of cluster number and size of coronavirus disease 2019 (COVID-19) in long-term care (LTC) hospitals/facilities, general medical/welfare facilities and non-medical/welfare facilities with morbidity and mortality in 47 prefectures during 16 January to 9 May 2020 in Japan. METHODS: Information on COVID-19 clusters (n ≥2), and morbidity and mortality of COVID-19 was collected. RESULTS: A total of 381 clusters with 3786 infected cases were collected, accounting for 23.9% of 15 852 cumulated cases on 9 May 2020. Although the cluster number (/107 subjects) in LTC hospitals/facilities was significantly smaller compared with those in the other two groups, the cluster size in LTC hospitals/facilities was significantly larger than that in non-medical/welfare facilities. Cluster numbers in general medical/welfare facilities and in non-medical/welfare facilities were significantly positively correlated with morbidity (/105 ), indicating relatively early identification of clusters in these facilities. Unlike in these facilities, cluster size in LTC hospitals/facilities was significantly positively correlated with morbidity, indicating that clusters in LTC hospitals/facilities were finally identified after already having grown to a large size in areas where infection was prevalent. Multivariate logistic regression analysis showed that both cluster number and cluster size only in LTC hospitals/facilities were independently associated with higher mortality (≥median 0.64/105 subjects) after adjustment. CONCLUSIONS: Preventive efforts against COVID-19 outbreaks even at the early phase of the epidemic are critically important in LTC hospitals/facilities, as both the larger number and size of clusters only in LTC hospitals/facilities were independently linked to higher mortality in prefectures in Japan. Geriatr Gerontol Int 2020; 20: 715-719.


Assuntos
Infecções por Coronavirus , Hospitais de Doenças Crônicas/estatística & dados numéricos , Assistência de Longa Duração , Pandemias , Pneumonia Viral , Instituições de Cuidados Especializados de Enfermagem/estatística & dados numéricos , Idoso , Betacoronavirus/isolamento & purificação , Análise por Conglomerados , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Feminino , Humanos , Controle de Infecções/organização & administração , Japão/epidemiologia , Assistência de Longa Duração/métodos , Assistência de Longa Duração/organização & administração , Assistência de Longa Duração/tendências , Masculino , Mortalidade , Pandemias/prevenção & controle , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle
3.
Cienc. tecnol. salud ; 7(1): 47-52, 2020.
Artigo em Espanhol | LILACS | ID: biblio-1120310

RESUMO

Los estudios de melanoma en Guatemala han sido pocos y únicamente se ha evaluado el aspecto clínico e histológico. El objetivo del presente estudio fue determinar la proporción de casos de melanoma cutáneo por morfología, inmunohistoquímica y mutación del gen BRAF en pacientes con diagnóstico de melanoma en dos centros de referencia, Instituto de Cancerología e Instituto de Dermatología en Guatemala. El estudio es de tipo descriptivo, retrospectivo, transversal. El tipo de muestreo es no probabilístico, con una muestra por conveniencia de 100 casos de tejidos de piel de pacientes, caracterizados por edad, sexo y localización del tumor. Los estudios moleculares incluyeron la determinación de la mutación de la proteína BRAF, por la técnica de PCR-RT. Los resultados muestran que el sexo más afectado es el femenino (54 %). El grupo etario con mayor número de casos es entre 56-75 años (44 %). El tipo histológico predominante es el melanoma lentiginoso acral (59 %) y la localización más frecuente es en miembro inferior (71 %). No se encontraron casos de melanoma lentigo maligno. La mutación del gen BRAF se encontró en el 6 % de los casos, lo que representa un dato importante para el pronóstico y tratamiento del paciente. Por ser uno de los primeros estudios que incluyen el factor molecular, abre paso a una línea de investigación que permita dar continuidad a los pacientes con melanoma en Guatemala, lo que permitirá determinar factores pronóstico y predictivos, así como tratamientos de los casos en estudio.


Studies of melanoma in Guatemala have been few and only the clinical and histological aspects have been evaluated. The objective of this study was to determine the proportion of cases of cutaneous melanoma by morphology, immunohistochemistry and mutation of the BRAF gene in patients diagnosed with Melanoma in two important reference centers, Institute of Cancerology (Incan) and Institute of Dermatology of Guatemala (Inderma). The study is descriptive, retrospective, transversal. The type of sampling is non-probabilistic, with a convenience sample calculation of 100 cases of patient skin biopsies, characterized by age, sex and tumor anatomic location. Molecular studies included the determination of the BRAF protein mutation by means of the RT-PCR technique. Results show that the most affected sex is the female (54 %). Age group with the highest number of cases is between 56 and 75 years old (44 % of cases). The histological type that predominated is acral lentiginous melanoma (59 %) and the most frequent location is in the lower limb (71 %). No cases of malignant lentigo melanoma were found in the cases studied. The BRAF gene mutation was found in 6 % of the cases, which represents an important data for the prognosis and treatment of the patient. In addition, being one of the first studies that include the molecular factor, it opens the way to a line of research that allows patients with melanoma to continue in Guatemala. This would allow to determine prognostic and predictive factors, as well as treatments of the cases under study.


Assuntos
Imuno-Histoquímica/métodos , Melanoma/diagnóstico , Mutação/genética , Neoplasias Cutâneas , Hospitais de Doenças Crônicas , Melanoma/patologia
4.
Rev. esp. salud pública ; 94: 0-0, 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192978

RESUMO

OBJETIVO: Los efectos de la emergencia sanitaria por la Covid-19 han demostrado la alta vulnerabilidad de las personas que residen en centros de media y larga estancia, con altas tasas de mortalidad. Se disponen de pocos datos acerca de los protocolos de contingencia para minimizar la propagación del virus en estos centros. El objetivo de este estudio fue describir las características clínicas y epidemiológicas de los pacientes afectados por el SARS-CoV-2, así como las medidas preventivas y de gestión adoptadas en el Hospital Nacional de Parapléjicos (Toledo) para minimizar el riesgo de transmisión de la Covid-19. MÉTODOS: Un equipo formado por especialistas en Medicina Preventiva y en Medicina Interna del Hospital Nacional de Parapléjicos estableció un protocolo de vigilancia activa, identificación de casos sospechosos y confirmados, así como de seguimiento de contactos. Además, se creó una Unidad para la atención de los casos confirmados, con personal formado específicamente en Covid-19, para intentar lograr una mejor atención de los pacientes y optimización de los recursos materiales disponibles. Para el análisis de los datos se han utilizado medidas estadísticas descriptivas. RESULTADOS: La prevalencia de la Covid-19 fue del 12,2%, con una incidencia acumulada del 8,2%. Tras la instauración del protocolo se logró el control de la enfermedad, sin transmisión intrahospitalaria posterior a su aplicación. Debido a la alarma generada al inicio de la pandemia, hasta un 45% de las RT-PCR solicitadas no cumplían los criterios del Ministerio de Sanidad, siendo todas negativas. Las características clínicas de nuestros pacientes difirieron ligeramente de las observadas en otros estudios publicados en población general, siendo la tos y la astenia los síntomas más frecuentes, presentes en el 69,2% y el 38,5% respectivamente. El 100% de los pacientes infectados no presentaron complicaciones que precisaran asistencia en Unidad de Cuidados Intensivos. CONCLUSIONES: Con la aplicación de las acciones preventivas y organizativas consideramos que hemos presentado una incidencia baja de infectados. Es indispensable la elaboración de protocolos y su supervisión para la rápida identificación de casos y optimizar las pruebas solicitadas. Pese a ser un hospital de media y larga estancia, no hemos presentado mortalidad ni complicaciones que requirieran ingreso en Unidad de Cuidados Intensivos


OBJECTIVE: The effects of the Covid-19 health emergency have demonstrated the high vulnerability of people residing in medium and long-stay centers, with high mortality rates. Little data is available about contingency protocols to minimize the spread of the virus in these centers. The goal of this study was to describe the clinical and epidemiological features of patients affected by SARS-CoV-2 and the preventive and management measures adopted at the National Hospital for Paraplegics (Toledo, Castilla-La Mancha, Spain) to minimize the risk of transmission of Covid-19. METHODS: A team of specialists in Preventive and Internal Medicine established a protocol for active surveillance, identification of suspected and confirmed cases, and follow-up of contacts. Also, a Unit for the care of confirmed cases was created with personnel specifically trained in Covid-19, to achieve better patient care and optimize the available resources. Descriptive statistical measures have been used to analyze the data. RESULTS: The prevalence of Covid-19 was 12.2%, with a cumulative incidence of 8.2%. After the protocol was established, control of the disease was achieved without hospital transmission after its application. Due to the alarm generated at the start of the pandemic, up to 45% of the requested RT-PCRs did not meet the criteria of the Ministry of Health, all of which were negative. The clinical characteristics of our patients differed slightly from those observed in other studies published in the general population, with cough and asthenia being the most frequent symptoms, present in 69.2% and 38.5%, respectively. 100% of the infected patients did not present complications that required assistance in the Intensive Care Unit. CONCLUSIONS: With the application of preventive and organizational actions, we consider that we have presented a low incidence of those infected. The preparation of protocols and their supervision is essential for the rapid identification of cases and optimization of the tests requested. Despite being a medium and long-stay hospital, we have not presented any mortality or complications that required admission to the Intensive Care Unit


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Infecção Hospitalar/prevenção & controle , Hospitais de Doenças Crônicas/organização & administração , Infecções por Coronavirus/prevenção & controle , Traumatismos da Medula Espinal/complicações , Saneamento de Hospitais , Infecções por Coronavirus/epidemiologia , Populações Vulneráveis , Monitoramento Epidemiológico , Precauções Universais/métodos , Pandemias , Pacotes de Assistência ao Paciente/métodos
5.
Technol Cult ; 60(4): 979-1003, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31761790

RESUMO

As drug-resistant strains of tuberculosis spread across India, commentators have warned that we are returning to the sanatorium era. Such concerns might be symptomatically read in terms of loss; however, prophecies of return might also signal that there is something to be regained. Rather than lamenting the end of the antibiotic era, I shift the focus to ask about the sanatorium, not simply as a technology of the past, but as a technology of an imminent future. In examining late nineteenth- and early twentieth-century conversations about treating tuberculosis in India, I demonstrate how the the sanatorium was figured as a therapeutic technology that mediated the relationship between the body and its colonial milieu. In this light, I argue that contemporary prophecies of a future past register not simply the loss of antibiotic efficacy, but also a desire to return to a therapeutics that foregrounds issues of vitality, mediation, and environment.


Assuntos
Hospitais de Doenças Crônicas/história , Tuberculose/história , Vitalismo/história , Colonialismo/história , História do Século XIX , História do Século XX , História do Século XXI , Humanos , Índia , Tuberculose/terapia
6.
Zhonghua Liu Xing Bing Xue Za Zhi ; 40(5): 559-564, 2019 May 10.
Artigo em Chinês | MEDLINE | ID: mdl-31177738

RESUMO

Objective: To understand the medical expenditure and related household economic burden of pulmonary tuberculosis (TB) patients receiving full course treatment in designated TB hospitals in China and identify the related factors. Method: A cross-sectional study was conducted in 535 consecutive TB patients receiving TB treatment from April 2017 to June 2017 in 5 designated TB hospitals in eastern and western China selected through stratified cluster sampling. A questionnaire was used to collect the information about patients' social economic characteristics and TB diagnosis and treatment expenditure. Results: The average total medical expenditure for TB treatment was 12 635.5 yuan (RMB), in which the direct medical expenditure accounted for 65.3% of the total. Nearly half of the total medical expenditure occurred in pre-treatment period. The expenditure in pre- treatment period was higher in the patients with low education level, newly treated patients, and initial sputum negative patients. The median (quartile) for the ratio of total medical expenditure to annual household income was 22%(10%-57%). Ordinal logistic regression analysis showed that low-level education background, lower household income, hospitalization and suffering from other chronic disease might increase the ratio of medical expenditure to annual household income. Conclusions: Medical expenditure for full course TB treatment is still high in patients in designated TB hospitals. It is suggested to strengthen the capability building of timely found and referral of TB patients in non- designated hospitals and improve fee reduction and exemption policy for some patients.


Assuntos
Antituberculosos/economia , Efeitos Psicossociais da Doença , Custos de Cuidados de Saúde , Gastos em Saúde , Hospitais de Doenças Crônicas , Tuberculose Pulmonar/economia , Antituberculosos/uso terapêutico , China/epidemiologia , Estudos Transversais , Humanos , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/epidemiologia
7.
Hist Cienc Saude Manguinhos ; 26(2): 519-536, 2019 Jun 19.
Artigo em Espanhol | MEDLINE | ID: mdl-31241673

RESUMO

This article discusses the various proposals and strategies to prevent the transmission of pulmonary tuberculosis in the City of Mexico from the 1920s decade onwards, when it was launched the first long-term campaign against the disease, and analyses the limitations and challenges faced until 1940. It looks upon the motives that led the need to contain the transmission of the disease to occupy a dominant role after ten years of civil war; it focuses on the models and strategies implemented, and examines the challenges faced by the construction and operation of the Huipulco Tuberculosis Sanatorium, a key component of the fight against tuberculosis at the international level since long ago.


Assuntos
Controle de Doenças Transmissíveis/história , Hospitais de Doenças Crônicas/história , Tuberculose/história , Transmissão de Doença Infecciosa/história , Transmissão de Doença Infecciosa/prevenção & controle , História do Século XX , Humanos , México , Tuberculose/reabilitação , Tuberculose/transmissão
8.
J Infect Chemother ; 25(9): 714-719, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30982726

RESUMO

Whether or not additional antibiotics with anti-tuberculosis agents are required to treat bacterial co-infection with pulmonary tuberculosis is unclear. We aimed to assess the impact of additional antibiotics on mortality in pulmonary tuberculosis patients whose sputum cultures were positive for general bacteria as a surrogate definition of bacterial pneumonia. This study was a single-center retrospective cohort using a propensity score analysis. We included patients who were admitted for pulmonary tuberculosis and whose sputum cultures were positive for general bacteria. The mortality of patients who received additional antibiotics was analyzed after adjusting for other variables, including the propensity score predicting treatment with additional antibiotics. We assessed 68 and 55 tuberculosis patients treated with and without general antibiotics, respectively. Additional antibiotics tended to be administered to patients with a high level of C-reactive protein and neutrophil count, poor performance status, hypoxemia and hypoalbuminemia (C-statistics of area under receiver operating characteristic curve to the propensity score; 0.884, p < 0.001). In the multivariate analysis, advanced age and not the use of additional antibiotics was associated with in-hospital mortality. Additional antibiotics with anti-tuberculosis agents may not improve the prognosis of pulmonary tuberculosis patients whose sputum cultures were positive for general bacteria. Isolation of general bacteria does not equate to complication with bacterial pneumonia, so physicians should not administer general antibiotics to TB patients based solely on the results of sputum culture for general bacteria. A prospective study is needed to verify these results using a more accurate definition of pulmonary tuberculosis complicated with bacterial pneumonia.


Assuntos
Antibacterianos/uso terapêutico , Pneumonia Bacteriana/complicações , Pneumonia Bacteriana/tratamento farmacológico , Tuberculose Pulmonar/complicações , Tuberculose Pulmonar/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Gestão de Antimicrobianos , Estudos de Coortes , Coinfecção , Feminino , Mortalidade Hospitalar , Hospitais de Doenças Crônicas , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Bacteriana/mortalidade , Pontuação de Propensão , Estudos Retrospectivos , Escarro/microbiologia , Tuberculose Pulmonar/mortalidade
9.
Hist. ciênc. saúde-Manguinhos ; 26(2): 519-536, abr.-jun. 2019.
Artigo em Espanhol | LILACS | ID: biblio-1012196

RESUMO

Resumen Este artículo estudia las diferentes propuestas y estrategias para prevenir los contagios de la tuberculosis pulmonar implementadas en la Ciudad de México a partir de la década de 1920, al comenzar la primera campaña de largo aliento contra esa enfermedad, y analiza las limitaciones y problemas a los que ésta se enfrentó hasta 1940. Se destaca por qué la contención de los contagios de esa enfermedad ocupó un lugar prioritario después de diez años de guerra civil; se presta atención a los modelos y estrategias implementados y se examinan los problemas por lo que atravesó la construcción y el funcionamiento del Sanatorio para Tuberculosos de Huipulco, sustento clave de la lucha antituberculosa desde tiempo atrás a nivel internacional.


Abstract This article discusses the various proposals and strategies to prevent the transmission of pulmonary tuberculosis in the City of Mexico from the 1920s decade onwards, when it was launched the first long-term campaign against the disease, and analyses the limitations and challenges faced until 1940. It looks upon the motives that led the need to contain the transmission of the disease to occupy a dominant role after ten years of civil war; it focuses on the models and strategies implemented, and examines the challenges faced by the construction and operation of the Huipulco Tuberculosis Sanatorium, a key component of the fight against tuberculosis at the international level since long ago.


Assuntos
Humanos , História do Século XX , Tuberculose/história , Controle de Doenças Transmissíveis/história , Hospitais de Doenças Crônicas/história , Tuberculose/reabilitação , Tuberculose/transmissão , Transmissão de Doença Infecciosa/história , Transmissão de Doença Infecciosa/prevenção & controle , México
10.
Explore (NY) ; 15(4): 291-294, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30910609

RESUMO

Human Immunodeficiency Virus (HIV) is an infection that poses a great threat to both developed and developing countries. Health facilities offering complementary care, along with standard care, have been considered as a useful strategy to overcome the burden of HIV and promote quality and wellbeing among people living with HIV/AIDS (PLWHA). In this report, we make reference to seven participants diagnosed with HIV, who underwent naturopathy and yoga based lifestyle intervention (NYLI), for varying durations, at a sanatorium for PLWHA. The cases suggest that NYLI functions as an adjuvant therapy that complements standard care, improves adherence and promotes health-related outcomes in HIV affiliated clinical markers, such as haemoglobin, weight and CD4+ counts. However, further controlled trials are required to establish warranting evidence.


Assuntos
Infecções por HIV/terapia , Naturopatia , Ioga , Adulto , Antirretrovirais/uso terapêutico , Peso Corporal , Contagem de Linfócito CD4 , Terapias Complementares , Feminino , Infecções por HIV/complicações , Infecções por HIV/psicologia , Hemoglobinas , Hospitais de Doenças Crônicas , Humanos , Índia , Masculino , Pessoa de Meia-Idade
11.
Infez Med ; 26(3): 280-282, 2018 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-30246774

RESUMO

The pathography of the famous painter and sculptor Amedeo Modigliani (1884-1920) shows that he had tuberculosis and died of tubercular meningitis aged 35. The nineteenth century was characterized by numerous milestones in the history of tuberculosis. In 1853, Hermann Brehmer, first used the term tuberculosis referred to at the time as "phthisis". In 1865, Jean Antoine Villemin demonstrated the infectious etiology of the disease. This was confirmed in 1882 by Robert Koch by identifying the tubercle bacillus. Koch also invented the diagnostic tuberculin test. Charles Mantoux and Florence Seibert improved this test. Identification of the infectious etiology of tuberculosis led to experiments of effective treatments for this disease. The most successful treatment for tuberculosis was by sanatorium regime. From the late nineteenth century, more invasive therapeutic approaches such as artificial pneumothorax were introduced. The advent of streptomycin in 1945 changed the social view of tuberculosis. This previously romanticized disease became a social stigma which was associated with poor social and moral standards; patients were kept in isolation. Fearing social ostracism, Modigliani refused treatment for tuberculosis and instead deliberately fostered his reputation as an alcoholic and addict in order to conceal the disease.


Assuntos
Pessoas Famosas , Pinturas/história , Escultura/história , Tuberculose Meníngea/história , Atitude Frente a Saúde , História do Século XIX , História do Século XX , Hospitais de Doenças Crônicas/história , Humanos , Itália , Masculino , Estigma Social , Transtornos Relacionados ao Uso de Substâncias/complicações , Recusa do Paciente ao Tratamento , Tuberculose Meníngea/complicações , Tuberculose Meníngea/psicologia
12.
Clin Dermatol ; 36(3): 421-425, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29908583

RESUMO

For centuries, patients afflicted with the peripheral nerve damaging disease, leprosy-sometimes referred to as Hansen's Disease-were excluded from society and harshly stigmatized. Such stigmatization often stemmed from the belief that the disease was a punishment by G-d for wrongdoing. Leprosy's origins remain rooted throughout various European countries; however, the disease established its presence in North America around the late 18th century. In particular, major port cities that experienced high volume trade, such as New Orleans, were most susceptible to infection. In response to the ensuing Louisiana leprosy endemic, various medical pioneers established the first hospital in America dedicated solely to the treatment of lepers, the Carville Leprosarium. The World Health Organization's treatment recommendation, multidrug therapy, is one of many lifesaving discoveries made at the facility located nearly 70 miles north of New Orleans. Since opening in 1894, the Carville Leprosarium has treated hundreds of Americans infected with Mycobacterium leprae, the disease-causing agent responsible for leprosy.


Assuntos
Hospitais de Doenças Crônicas/história , Hanseníase/história , História do Século XVIII , História do Século XIX , História do Século XX , Humanos , Hanseníase/tratamento farmacológico , Louisiana , Museus
13.
J Glob Antimicrob Resist ; 14: 17-22, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29476986

RESUMO

OBJECTIVES: This study aimed to describe trends in antituberculosis drug prescribing for inpatients from 2011-2015 in a Chinese national tuberculosis (TB) hospital. METHODS: This retrospective study, performed in March 2016, reviewed the medical records of all inpatients from Beijing Chest Hospital diagnosed with TB between 2011-2015. Medication used for TB treatment during the inpatient period was recorded. RESULTS: A total of 11465 inpatients were enrolled in the study. The most frequently prescribed drug for inpatients was isoniazid (71.2%; 8164/11465), followed by ethambutol (67.5%; 7738/11465), pyrazinamide (59.7%; 6839/11465) and rifampicin (40.0%; 4589/11465). In addition, amikacin (16.5%; 1889/11465), levofloxacin (33.0%; 3789/11465), para-aminosalicylic acid (12.4%; 1422/11465) and clarithromycin (3.5%; 406/11465) were the most common drugs used in the treatment of inpatients for Group II, III, IV and V drugs, respectively. A significant increasing trend in prescribing was found for rifampicin, pyrazinamide, capreomycin, moxifloxacin, prothionamide, para-aminosalicylic acid, cycloserine, clofazimine and linezolid, respectively, whilst there was a significant decreasing trend in the rate of prescribing of ethambutol, amikacin, levofloxacin, amoxicillin/clavulanic acid and clarithromycin during the 5-year study period (Ptrend<0.01). CONCLUSIONS: These data demonstrate that prescription of anti-TB drugs varied greatly across clinical diagnostic categories, treatment history and drug susceptibility profiles of TB patients. The World Health Organization (WHO)-endorsed standard regimen should be more extensively employed under conditions where drug susceptibility testing is unavailable in order to guide clinicians to formulate a suitable treatment regimen for TB patients.


Assuntos
Antituberculosos/uso terapêutico , Prescrições de Medicamentos/estatística & dados numéricos , Tuberculose Extensivamente Resistente a Medicamentos/tratamento farmacológico , China , Hospitais de Doenças Crônicas/estatística & dados numéricos , Humanos , Pacientes Internados , Isoniazida/uso terapêutico , Linezolida/uso terapêutico , Registros Médicos , Testes de Sensibilidade Microbiana , Mycobacterium tuberculosis , Estudos Retrospectivos , Rifampina/uso terapêutico
14.
J Prev Med Hyg ; 59(4): E323-E327, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30656236

RESUMO

Since ancient times, the most frequently prescribed remedy for the treatment of tuberculosis was a stay in a temperate climate. From the middle of the 19th century to the middle of the 20th, Europe saw the development of sanatoria, where patients were able to benefit from outdoor walks, physical exercise and a balanced diet. Moreover, the institutionalisation and isolation of patients deemed to be contagious remains one of the most efficacious measures for the control of this type of infection. The first sanatorium opened in Germany in 1854, while in Italy the earliest experiments were conducted at the beginning of the 20th century. At that time, it was widely believed in Italy that pulmonary tuberculosis could improve in a marine climate. By contrast, the scholar Biagio Castaldi described the salubrious effects of mountain air and documented a lower incidence of tuberculosis among mountain populations, which supported the hypothesis of a hereditary predisposition to the disease. In 1898, several local committees (Siena, Pisa, Padua) were founded to fight tuberculosis. The following year, these gave rise to the Lega Italiana (Italian League) under the patronage of the King of Italy, which helped to promote state intervention in the building of sanatoria. The pioneer of the institution of dedicated facilities for the treatment of tuberculosis was Edoardo Maragliano in Genoa in 1896. A few years later, in 1900, the first specialised hospital, with a capacity of 100 beds, was built in Budrio in a non-mountainous area, the aim being to treat patients within their habitual climatic environment. In the following years, institutes were built in Bologna, Livorno, Rome, Turin and Venice. A large sanatorium for the treatment of working-class patients was constructed in Valtellina by the fascist government at the beginning of the century, in the wake of studies by Eugenio Morelli on the climatic conditions of the pine woods in Sortenna di Sondalo, which he deemed to be ideal. In December 1916, the Italian Red Cross inaugurated the first military sanatorium in the "Luigi Merello" maritime hospice in Bergeggi (SV) to treat soldiers affected by curable tuberculosis. In 1919, a specific law mandated a 10-fold increase in funding for the construction of dispensaries and sanatoria. As a result, the Provincial Anti-tuberculosis Committees were transformed into Consortiums of municipal and provincial authorities and anti-TB associations, with the aim of coordinating the action to be undertaken. In 1927, the constitution of an Anti-tuberculosis Consortium in every province became a legal obligation. Despite this growth in social and healthcare measures, tuberculosis in Italy continued to constitute a major public health problem until the advent of antibiotics in the 1950s. Until that time, the sanatorium played a leading role in the treatment of tuberculosis in Italy, as in the rest of Europe.


Assuntos
Hospitais de Doenças Crônicas/história , Tuberculose , História do Século XIX , História do Século XX , Humanos , Itália , Sociedades , Tuberculose/prevenção & controle , Tuberculose/terapia
15.
J Prev Med Hyg ; 59(4): E328-E335, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30656237

RESUMO

Despite considerable efforts and quite early initiated anti-tuberculosis (TB) actions, Lithuania still remains one of the European Union (EU) countries with the highest tuberculosis rates, especially multidrug-resistant (MDR) TB. According to the European Centre for Disease Prevention and Control, in 2016, 58 994 cases of TB were reported in 30 EU/European Economic Area (EEA) countries. MDR TB was reported for 3.7% of 36 071 cases with drug susceptibility testing results and continues to be highest in the three Baltic countries - Estonia, Latvia and Lithuania. In this article we present the Lithuanian anti-TB action history review and comparison with other countries in this area of action. Literature review was performed by using documents available in the Martynas Mazvydas Library's resource, articles of foreign authors and archival materials. According to archaeological studies, tuberculosis was common in Europe including Lithuania in the Middle Ages. Tuberculosis reporting started in Lithuania in 1926. The first tuberculosis sanatorium in Lithuania was opened in 1891. Patients were treated with sun bathing procedures, fresh air and sunlight. Later the treatment included pneumothorax, toracocaustic, toracoplastic, treatment with gold products and other procedures. Lithuania introduced directly observed treatment, short course therapy (DOTS) in 1999, and since 2007 it has been working in accordance with the requirements of this strategy.


Assuntos
Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/prevenção & controle , Tuberculose Pulmonar/história , Europa (Continente)/epidemiologia , História do Século XIX , História do Século XX , Hospitais de Doenças Crônicas/história , Humanos , Testes de Sensibilidade Microbiana , Vigilância da População , Saúde Pública
16.
Bull Hist Med ; 91(4): 772-801, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29276191

RESUMO

In 1936, Fulgencio Batista, the head of the Cuban military (and the de facto ruler of Cuba), founded the National Tuberculosis Council (CNT) to lead a state-directed anti-tuberculosis campaign. While most national and colonial governments neglected tuberculosis until the postwar period, populist politics pushed Batista to prioritize a disease of poverty by the mid-1930s. However, national politics also undermined efforts to control the disease in Cuba. Authoritarianism facilitated Batista's considerable influence over tuberculosis policy, and he and his advisors pursued political objectives rather than following the technical advice offered by professional groups. As a result, the administration of the campaign was inefficient, nowhere more notably than in the CNT's premiere project, the Topes de Collantes National Sanatorium. Citizen and physician discontent with this project, the anti-tuberculosis campaign, and the state health sector fed into processes of political delegitimation and regime change in the 1950s.


Assuntos
Hospitais de Doenças Crônicas/história , Política , Tuberculose/história , Cuba , História do Século XX , Hospitais de Doenças Crônicas/legislação & jurisprudência , Hospitais de Doenças Crônicas/organização & administração , Humanos , Tuberculose/terapia
17.
Infez Med ; 25(4): 381-394, 2017 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-29286022

RESUMO

In the late nineteenth century, with industrial growth and the resulting mass urbanisation, tuberculosis represented a plague mainly among the poor social classes. The outdated and crowded Italian prisons (formerly old monasteries) during the early 1900s were insufficient to "host" the multitude of inmates condemned or waiting for judgment. Italian prisoners were beset by hunger and poor hygiene facilities. Clothes did not differ between winter and summer. The Criminal Sanatorium of Pianosa was officially inaugurated in 1907, but from the 1860s it had been set up to host an agricultural penal colony. Here we report the excellent results obtained between 1907 and 1909 in the management of tuberculosis among prisoners in Pianosa, where surgery was also available. In those times, climate therapy with an enriched and varied nutrition was the only effective treatment for tuberculosis. Overall, of the 913 prisoners housed in Pianosa in that period and according to the acknowledged scientific criteria, the following results were achieved: complete cure in 182, improvement in 416, mild amelioration in 94, worsening in 80, no change in 20. The number of prisoners who died or were transferred to another prison is unknown. The case series of the prison hospital in Pianosa may be reconstructed thanks to data published by the Director Roberto Passini. The better outcome of the prisoners in Pianosa, in comparison with inmates of other Italian institutions, was due both to treatment standards (climate, nutritional, hygienic, and surgical) and to the proportionally longer period of stay in Pianosa for prisoners with already confirmed detention periods.


Assuntos
Prisioneiros/história , Tuberculose/história , História do Século XIX , Hospitais de Doenças Crônicas/história , Hospitais Especializados/história , Humanos , Higiene , Itália/epidemiologia , Masculino , Tuberculose/epidemiologia , Tuberculose/transmissão
18.
Biomed Environ Sci ; 30(9): 691-694, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29081346

RESUMO

Nosocomial infections (NIs) are a critical issue affecting the quality of healthcare. In this study, we performed a retrospective study to explore the incidence rates, mortality rates, and microbial spectrum of NIs in Beijing Chest Hospital, a tuberculosis (TB) specialized hospital in China. Our data demonstrate that the overall incidence rate of inpatients with NIs slightly decreased from 2012 to 2016, which may be associated with the implementation of hand hygiene measures, while the mortality rates associated with NI did not significantly change. In addition, the species distribution of NIs was quite different from that presented in previous reports, and Klebsiella pneumoniae was the most frequently isolated microorganism.


Assuntos
Infecção Hospitalar/epidemiologia , Controle de Infecções , Tuberculose/epidemiologia , Bactérias/classificação , Bactérias/isolamento & purificação , Pequim , Infecção Hospitalar/microbiologia , Infecção Hospitalar/mortalidade , Hospitais de Doenças Crônicas , Humanos , Vigilância da População , Estudos Retrospectivos , Tuberculose/terapia
19.
Artigo em Russo | MEDLINE | ID: mdl-28665376

RESUMO

The main statistical indicators of the activities of physiotherapy units (PTU) in the tuberculosis dispensaries (TBD) of Saint Petersburg are presented. Monitoring the compliance of the equipment available in PTU of TBD with the requirements of the modern Health Care Standard for the patients suffering from tuberculosis (TB) as approved by the Ministry of Health of the Russian Federation has been carried out. It has demonstrated that the current state of medical care in this country provides but the limited availability of the physiotherapeutic treatment for the TB patients. At the same time, the high coverage of the patients suffering from tuberculosis with physical therapy based at the day tuberculosis dispensaries of Saint Petersburg has been documented.


Assuntos
Assistência à Saúde , Hospitais de Doenças Crônicas , Modalidades de Fisioterapia , Tuberculose/terapia , Feminino , Humanos , Masculino , Federação Russa/epidemiologia , Tuberculose/epidemiologia
20.
J Korean Med Sci ; 32(7): 1105-1110, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28581266

RESUMO

Although several reports about drug-resistant tuberculosis (TB) in North Korea have been published, a nationwide surveillance on this disease remains to be performed. This study aims to analyze the drug resistance patterns of Mycobacterium tuberculosis among the patients in the sanatoria of North Korea, especially during the period when second-line drugs (SLDs) had not yet been officially supplied to this country. The Eugene Bell Foundation (EBF) transferred 947 sputum specimens obtained from 667 patients from 2007 to 2009 to the Clinical Research Center, Masan National Tuberculosis Hospital (MNTH), South Korea. Four hundred ninety-two patients were culture positive for TB (73.8%). Drug susceptibility test (DST) was performed for the bacilli isolated from 489 patients. Over 3 quarters of the cases (76.9%) were multidrug-resistant (MDR)-TB. Additionally, 2 patients had extremely drug-resistant (XDR)-TB. Very high resistance to first-line drugs and low resistance to fluoroquinolones (FQs) and injectable drugs (IDs) except for streptomycin (S) were detected. A small but significant regional variation in resistance pattern was observed. Big city regions had higher rate of MDR-TB, higher resistance to FQs and IDs than relatively isolated regions. In conclusion, significant number of drug-resistant TB was detected in North Korean sanatoria, and small but significant regional variations in resistance pattern were noticeable. However, the data in this study do not represent the nationwide drug resistance pattern in North Korea. Further large-scale evaluations are necessary to estimate the resistance pattern of TB in North Korea.


Assuntos
Farmacorresistência Bacteriana Múltipla , Hospitais de Doenças Crônicas/estatística & dados numéricos , Mycobacterium tuberculosis/efeitos dos fármacos , Tuberculose Resistente a Múltiplos Medicamentos/epidemiologia , Tuberculose Pulmonar/epidemiologia , Antituberculosos/uso terapêutico , República Democrática Popular da Coreia/epidemiologia , Humanos , Mycobacterium tuberculosis/isolamento & purificação , República da Coreia/epidemiologia , Tuberculose Resistente a Múltiplos Medicamentos/tratamento farmacológico , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico
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