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1.
An. pediatr. (2003. Ed. impr.) ; 92(4): 241.e1-241.e11, abr. 2020. mapas, graf, tab
Artigo em Espanhol | IBECS | ID: ibc-186847

RESUMO

El 31 de diciembre de 2019, la Comisión Municipal de Salud y Sanidad de Wuhan (provincia de Hubei, China) informó sobre la existencia de 27 casos de neumonía de etiología desconocida con inicio de síntomas el 8 de diciembre, incluyendo 7 casos graves, con exposición común a un mercado de marisco, pescado y animales vivos en la ciudad de Wuhan. El 7 de enero de 2020, las autoridades chinas identificaron como agente causante del brote un nuevo tipo de virus de la familia Coronaviridae, denominado temporalmente «nuevo coronavirus», 2019-nCoV. El 30 de enero de 2020 la Organización Mundial de la Salud (OMS) declara el brote una Emergencia Internacional. El día 11 de febrero la OMS le asigna el nombre de SARS-CoV2 e infección COVID-19 (Coronavirus Infectious Disease). El Ministerio de Sanidad convoca a las Sociedades de Especialidades para la elaboración de un protocolo clínico de manejo de la infección. La Asociación Española de Pediatría nombra un grupo de trabajo de las Sociedades de Infectología Pediátrica y Cuidados Intensivos Pediátricos que se encargan de elaborar las presentes recomendaciones con la evidencia disponible en el momento de su realización


On 31 December 2019, the Wuhan Municipal Committee of Health and Healthcare (Hubei Province, China) reported that there were 27 cases of pneumonia of unknown origin with symptoms starting on the 8 December. There were 7 serious cases with common exposure in market with shellfish, fish, and live animals, in the city of Wuhan. On 7 January 2020, the Chinese authorities identified that the agent causing the outbreak was a new type of virus of the Coronaviridae family, temporarily called «new coronavirus», 2019-nCoV. On January 30th, 2020, the World Health Organisation (WHO) declared the outbreak an International Emergency. On 11 February 2020 the WHO assigned it the name of SARS-CoV2 and COVID-19 (SARS-CoV2 and COVID-19). The Ministry of Health summoned the Specialties Societies to prepare a clinical protocol for the management of COVID-19. The Spanish Paediatric Association appointed a Working Group of the Societies of Paediatric Infectious Diseases and Paediatric Intensive Care to prepare the present recommendations with the evidence available at the time of preparing them


Assuntos
Humanos , Lactente , Pré-Escolar , Criança , Adolescente , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Coronavirus/classificação , Coronavirus/genética , Reação em Cadeia da Polimerase em Tempo Real , Índice de Gravidade de Doença , Sociedades Médicas , Espanha
2.
Rev. enferm. UERJ ; 28: e48443, jan.-dez. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1116092

RESUMO

Objetivo: comparar o comportamento de pré-escolares durante o uso de administração por inalação, antes e após sessão de Brinquedo Terapêutico. Método: estudo quase-experimental de abordagem quantitativa, com a técnica de observação antes e após a intervenção, realizado por meio de amostra intencional, recrutadas em uma Unidade de Pronto Atendimento no interior de Minas Gerais. Os dados foram analisados por estatística descritiva e inferencial, coletados entre os meses de novembro de 2017 a abril de 2018. Resultados: foram avaliados 25 comportamentos de 99 pré-escolares durante a administração por inalação. Após a sessão, 73,7% estavam com a postura e expressão facial relaxada, 76,8% estavam à vontade, 19,2% interromperam o procedimento e 38,4 % solicitaram a presença da mãe ou acompanhante. Conclusão: o uso do brinquedo, favoreceu maior aceitação e adaptação de pré-escolares submetidos à administração por inalação, evidenciado a importância em implementar essa estratégia em serviços de pronto atendimento pediátrico.


Objective: to compare the behavior of preschoolers during inhalation therapy, before and after a Therapeutic Play session. Method: quasi-experimental, quantitative study using pre- and post-intervention observation with an intentional sample recruited at an Emergency Care Unit in Minas Gerais. Data were collected from November 2017 to April 2018 and analyzed by descriptive and inferential statistics. Results: twenty-five behaviors of 99 preschoolers were evaluated during inhalation administration. After the session, 73.7% were relaxed in posture and facial expression, 76.8% were comfortable, 19.2% interrupted the procedure, and 38.4% requested the mother or companion to be present. Conclusion: the use of toys favored greater acceptance and adaptation by preschoolers undergoing inhalation therapy, evidencing the importance of implementing this strategy in pediatric emergency services.


Objetivo: comparar el comportamiento de los preescolares durante la terapia de inhalación, antes y después de una sesión de Juego Terapéutico. Método: estudio cuantitativo cuasi-experimental utilizando observación previa y posterior a la intervención con una muestra intencional reclutada en una Unidad de Atención de Emergencia en Minas Gerais. Los datos se recopilaron de noviembre de 2017 a abril de 2018 y se analizaron mediante estadísticas descriptivas e inferenciales. Resultados: se evaluaron veinticinco comportamientos de 99 niños en edad preescolar durante la administración por inhalación. Después de la sesión, el 73.7% se relajó en la postura y la expresión facial, el 76.8% se sintió cómodo, el 19.2% interrumpió el procedimiento y el 38.4% solicitó que la madre o la acompañante estuvieran presentes. Conclusión: el uso de juguetes favoreció una mayor aceptación y adaptación por parte de los preescolares sometidos a terapia de inhalación, lo que evidencia la importancia de implementar esta estrategia en los servicios de emergencia pediátricos.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Jogos e Brinquedos/psicologia , Administração por Inalação , Comportamento Infantil/psicologia , Técnicas de Observação do Comportamento , Relações Enfermeiro-Paciente , Cuidados de Enfermagem/métodos
3.
Texto & contexto enferm ; 29: e20180348, Jan.-Dec. 2020. tab
Artigo em Inglês | LILACS, BDENF - Enfermagem | ID: biblio-1059138

RESUMO

ABSTRACT Objective: To identify the factors associated with clinical deterioration recognized by a Pediatric Early Warning Score. Method: A cross-sectional study conducted in a tertiary pediatric public hospital with 271 children aged from zero to ten, hospitalized between May and October 2015. For the identification of the children with and without signs of clinical deterioration, the translated, adapted and validated version of the Brighton Pediatric Early Warning Score was applied to the Brazilian context. Logistic regression analysis and prevalence ratio (PR) were used to measure the association between the variables studied. A 95% Confidence Interval (CI) and p value were adopted as a measure of statistical significance to identify potential associated factors. Results: The factors associated with the clinical deterioration of the children studied were age ≤ 2 years old (p=0.000), hospitalization in the emergency unit (p=0.000), comorbidity (p=0.020) and clinical diagnosis of respiratory disease (p=0.000). Conclusion: Children ≤ 2 years old, with comorbidity, diagnosed with respiratory disease and hospitalized in the emergency unit showed an increased likelihood of clinical deterioration. The identification of factors associated with clinical deterioration may alert and direct the health team to children more susceptible to this phenomenon.


RESUMEN Objetivo: identificar los factores asociados al deterioro clínico reconocido por una Puntuación Pediátrica de Alerta Temprana. Método: estudio de corte transversal realizado en un hospital público pediátrico terciario con 271 niños de cero a diez años de edad, hospitalizados entre mayo y octubre de 2015. Para identificar a los niños con y sin signos de deterioro clínico, se aplicó la versión traducida, adaptada y validad del Brighton Pediatric Early Warning Score para el contexto brasileño. Se utilizaron el análisis de regresión logística y la relación de prevalencia (RP) para medir la asociación entre las variables estudiadas. Se adoptaron el Intervalo de Confianza (IC) del 95% y el Valor de p como medida de significancia estadística para identificar los potenciales factores asociados. Resultados: los factores asociados al deterioro clínico de los niños estudiados fueron los siguientes: edad ≤ 2 años (p=0,000), internación en la unidad de emergencia (p=0,000), comorbilidad (p=0,020) y diagnóstico clínico de enfermedad respiratoria (p=0,000). Conclusión: los niños con una edad máxima de 2 años, con alguna comorbidad, con diagnóstico de enfermedad respiratoria e internadas en la unidad de emergencia presentaron una mayor probabilidad de deterioro clínico. Identificar factores asociados al deterioro clínico puede servir como alerta y orientar al equipo de salud hacia los niños más susceptibles a este fenómeno.


RESUMO Objetivo: identificar os fatores associados à deterioração clínica reconhecida por um Escore Pediátrico de Alerta Precoce. Método: estudo de corte transversal, realizado num hospital público pediátrico terciário, com 271 crianças de zero a dez anos, hospitalizadas entre maio e outubro de 2015. Para a identificação das crianças com e sem sinais de deterioração clínica, foi aplicada a versão traduzida, adaptada e validada do Brighton Pediatric Early Warning Score para o contexto brasileiro. Foram utilizadas a análise de regressão logística e a razão de prevalência (RP) para medir a associação entre as variáveis estudadas. O Intervalo de Confiança (IC) de 95% e Valor de p foram adotados como medida de significância estatística para a identificação dos potenciais fatores associados. Resultados: os fatores associados à deterioração clínica das crianças estudadas foram idade ≤ 2 anos (p=0,000), internamento na unidade de emergência (p=0,000), comorbidade (p=0,020) e diagnóstico clínico de doença respiratória (p=0,000). Conclusão: crianças ≤ 2 anos, portadoras de comorbidade, com diagnóstico de doença respiratória e internadas na unidade de emergência apresentaram aumento da probabilidade de deterioração clínica. A identificação de fatores associados à deterioração clínica pode alertar e direcionar a equipe de saúde para crianças mais suscetíveis a esse fenômeno.


Assuntos
Humanos , Recém-Nascido , Lactente , Pré-Escolar , Criança , Enfermagem Pediátrica , Criança Hospitalizada , Saúde , Saúde da Criança , Deterioração Clínica , Alerta , Hospitalização
4.
Texto & contexto enferm ; 29: e20200156, Jan.-Dec. 2020.
Artigo em Inglês, Português | LILACS, BDENF - Enfermagem | ID: biblio-1117301

RESUMO

Objetivo: identificar en la literatura la producción científica sobre exámenes y manifestaciones clínicas de COVID-19 en niños y discutir el papel de la enfermería en su atención. Métodos: revisión integradora, cuya búsqueda tuvo lugar entre abril y junio de 2020, en las bases de datos de Web of Science, CINAHL, BDENF, IBECS, LILACS, MEDLINE (a través de PubMed) para responder a la pregunta orientadora: lo que revelan los artículos de investigación sobre COVID -19 en niños? Se incluyeron artículos de investigación originales, publicados de enero a mayo de 2020. Estudios sin metodología de investigación (informes de casos, reflexión, recomendaciones), artículos de revisión, estudios que se centraron en otros temas o se llevaron a cabo exclusivamente con recién nacidos, bebés, población de adolescentes y adultos. Resultados: las búsquedas en las bases de datos buscadas capturaron 314 referencias. Después de las exclusiones, se seleccionaron 59 estudios para ser leídos en su totalidad; de estos, se seleccionaron 14 artículos para componer esta revisión, agrupados empíricamente, de acuerdo con sus similitudes, en dos categorías: Exámenes utilizados en COVID-19 en niños; y Principales hallazgos clínicos en COVID-19 en niños. Conclusión: los estudios enfatizan los exámenes COVID-19 y los hallazgos clínicos en niños; por lo tanto, el papel de la enfermería se destaca al preparar y realizar estos exámenes, ya que son un instrumento para evaluar y monitorear a los niños con COVID-19, así como para promover una atención adecuada y calificada para minimizar los signos y síntomas de esta enfermedad. enfermedad, con miras a la pronta restauración de su salud.(AU)


Objective: to identify in nursing literature scientific production on tests and clinical characteristics of COVID-19 in children and discuss the role of nursing in their care. Methods: an integrative review, which took place between April and June 2020, at Web of Science, CINAHL, BDENF, IBECS, LILACS, MEDLINE (via PubMed) to answer the guiding question: what do research articles on COVID-19 in children reveal? Original research articles published from January to May 2020 were included. Studies without research methodology (case reports, reflection, recommendations), review articles, studies focusing on other themes or conducted exclusively with neonates, infants, adolescents, and adults were excluded. Results: database search found 314 references. After exclusions, 59 studies were selected to be read in full. Of these, 14 articles were selected to compose this review, empirically grouped according to their similarities into two categories: Tests used in COVID-19 in children and Main clinical findings of COVID-19 in children. Conclusion: studies emphasize clinical tests and findings of COVID-19 in children; therefore, the role of nursing at the time of preparation and performance of such tests stands out, since they are an instrument for assessment and follow-up of children with coronavirus as well as in the promotion of adequate and qualified care to minimize the signs and symptoms of this disease, with a view to prompt restoration of their health.(AU)


Objetivo: identificar en la literatura la producción científica sobre exámenes y manifestaciones clínicas de COVID-19 en niños y discutir el papel de la enfermería en su atención. Métodos: revisión integradora, cuya búsqueda tuvo lugar entre abril y junio de 2020, en las bases de datos de Web of Science, CINAHL, BDENF, IBECS, LILACS, MEDLINE (a través de PubMed) para responder a la pregunta orientadora: lo que revelan los artículos de investigación sobre COVID -19 en niños? Se incluyeron artículos de investigación originales, publicados de enero a mayo de 2020. Estudios sin metodología de investigación (informes de casos, reflexión, recomendaciones), artículos de revisión, estudios que se centraron en otros temas o se llevaron a cabo exclusivamente con recién nacidos, bebés, población de adolescentes y adultos. Resultados: las búsquedas en las bases de datos buscadas capturaron 314 referencias. Después de las exclusiones, se seleccionaron 59 estudios para ser leídos en su totalidad; de estos, se seleccionaron 14 artículos para componer esta revisión, agrupados empíricamente, de acuerdo con sus similitudes, en dos categorías: Exámenes utilizados en COVID-19 en niños; y Principales hallazgos clínicos en COVID-19 en niños. Conclusión: los estudios enfatizan los exámenes COVID-19 y los hallazgos clínicos en niños; por lo tanto, el papel de la enfermería se destaca al preparar y realizar estos exámenes, ya que son un instrumento para evaluar y monitorear a los niños con COVID-19, así como para promover una atención adecuada y calificada para minimizar los signos y síntomas de esta enfermedad. enfermedad, con miras a la pronta restauración de su salud.(AU)


Assuntos
Humanos , Pré-Escolar , Criança , Enfermagem Pediátrica , Diagnóstico de Enfermagem , Infecções por Coronavirus , Saúde da Criança , Revisão
5.
Goiânia; s.n; out. 02, 2020. 1-24 p. ilus, tab, mapas, graf.(Boletim Epidemiológico Covid-19, 26).
Monografia em Português | Coleciona SUS, CONASS, SES-GO | ID: biblio-1121439

RESUMO

O Boletim Epidemiológico COVID-19 objetiva documentar e divulgar informações oficiais atualizadas da situação epidemiológica no Estado de Goiás-GO, Brasil. Resume que desde os primeiros registros na China em dezembro de 2019 até o dia 26 de setembro foram confirmados 32.730.945 casos de COVID-19 no mundo. Deste total, 991.224 evoluíram a óbito. Quando comparados o número de casos e óbitos confirmados desta semana epidemiológica (SE 39) com a semana anterior, houve aumento de 6,7% nos casos e 3,8% nos óbitos. Sintetiza que, no Brasil, neste mesmo intervalo de tempo, o aumento foi 4,2% e 3,5% no número de casos e óbitos, respectivamente. No país o primeiro caso foi confirmado no dia 26 de fevereiro e até 26 de setembro foram registrados 4.717.991 casos confirmados com 141.406 óbitos. Informa que o registro dos primeiros casos suspeitos em Goiás foi a partir de 04 de fevereiro e até 26 de setembro foram notificados à Vigilância Epidemiológica 595.334 casos de COVID-19. Infere que, nesta última semana epidemiológica (SE 39) houve a confirmação de 17.551 casos novos, representando um aumento nos casos de COVID-19 de 9,5%, superior ao aumento observado no Brasil 4,2%. No Estado, 202.528 (34,0%) foram confirmados sendo 196.210 (96,9%) por critério laboratorial, 4.408 (2,2%) pelo critério clínico-epidemiológico, 589 (0,3%) por critério clínico imagem e 802 (0,4%) pelo critério clínico, 148.086 (24,9%) foram descartados e 221.461 (37,2%) continuam como suspeitos


The COVID-19 Epidemiological Bulletin aims to document and disseminate updated official information on the epidemiological situation in the State of Goiás-GO, Brazil. It summarizes that since the first registrations in China in December 2019 until the 26th of September, 32,730,945 cases of COVID-19 have been confirmed worldwide. Of this total, 991,224 died. When comparing the number of confirmed cases and deaths of this epidemiological week (SE 39) with the previous week, there was an increase of 6.7% in cases and 3.8% in deaths. It synthesizes that, in Brazil, in this same time interval, the increase was 4.2% and 3.5% in the number of cases and deaths, respectively. In the country, the first case was confirmed on February 26 and until September 26, 4,717,991 confirmed cases were recorded, with 141,406 deaths. Informs that the record of the first suspected cases in Goiás was from February 4 and until September 26, 595,334 cases of COVID-19 were notified to the Epidemiological Surveillance. It infers that, in this last epidemiological week (SE 39), 17,551 new cases were confirmed, representing an increase in the cases of COVID-19 of 9.5%, higher than the increase observed in Brazil 4.2%. In the State, 202,528 (34.0%) were confirmed, 196,210 (96.9%) by laboratory criteria, 4,408 (2.2%) by clinical-epidemiological criteria, 589 (0.3%) by clinical image criteria and 802 (0.4%) by the clinical criterion, 148,086 (24.9%) were discarded and 221,461 (37.2%) remain as suspects


Assuntos
Humanos , Animais , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/epidemiologia , Betacoronavirus , Brasil/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Monitoramento Epidemiológico
7.
Goiânia; s.n; out. 09, 2020. ilus, tab, mapas, graf.(Boletim Epidemiológico Covid-19, 27).
Monografia em Português | Coleciona SUS, CONASS, SES-GO | ID: biblio-1122129

RESUMO

Através do Boletim Epidemiológico Covid 19 n° 27, a Secretaria Estadual de Saúde do Estado de Goiás, Brasil, tem o objetivo de informar a situação epidemiológica no período de 02 de fevereiro à 03 de outubro do ano de 2020, considerando que desde os primeiros registros na China em dezembro de 2019 até o dia 03 de outubro foram confirmados 34.804.348 casos de COVID-19 no mundo. Deste total, 1.030.738 evoluíram a óbito. Quando comparados o número de casos e óbitos confirmados desta semana epidemiológica (SE 40) com a semana anterior, houve aumento de 6,3% nos casos e 4,0%nos óbitos. No Brasil, neste mesmo intervalo de tempo, o aumento foi 4,4% e 3,7% no número de casos e óbitos, respectivamente. No país o primeiro caso foi confirmado no dia 26 de fevereiro e até 03 de setembro foram registrados 4.927.235 casos confirmados com 146.675 óbitos. O registro dos primeiros casos suspeitos em Goiás foi a partir de 04 de fevereiro e até 03 de outubro foram notificados à Vigilância Epidemiológica 630.054 casos de COVID-19. Nesta última semana epidemiológica (SE 40) houve a confirmação de 13.468 casos novos, representando um aumento nos casos de COVID-19 de 6,6%, superior ao aumento observado no Brasil 4,4%. No Estado, 215.996(34,3%) foram confirmados sendo 208.780(96,7%) por critério laboratorial, 4.920(2,3%) pelo critério clínico-epidemiológico, 660(0,3%) por critério clínico-imagem e 1.144(0,5%) pelo critério clínico, 160.855(25,5%) foram descartados e 225.955(35,9%) continuam como suspeitos


Through the Epidemiological Bulletin Covid 19 n° 27, the State Department of Health of the State of Goiás, Brazil, aims to inform the epidemiological situation in the period from February 2 to October 3 of the year 2020, considering that from the first records in China in December 2019 to October 3, 34,804,348 cases of COVID-19 worldwide were confirmed. Of this total, 1,030,738 died. When comparing the number of confirmed cases and deaths of this epidemiological week (SE 40) with the previous week, there was an increase of 6.3% in cases and 4.0% in deaths. In Brazil, in this same time interval, the increase was 4.4% and 3.7% in the number of cases and deaths, respectively. In the country the first case was confirmed on February 26 and until September 3, 4,927,235 confirmed cases were recorded with 146,675 deaths. The record of the first suspected cases in Goiás was from February 4 and until October 3 were notified to the Epidemiological Surveillance 630,054 cases of COVID-19. In this last epidemiological week (SE 40) there was the confirmation of 13,468 new cases, representing an increase in cases of COVID-19 of 6.6%, higher than the increase observed in Brazil 4.4%. In the State, 215,996 (34.3%) were confirmed being 208,780 (96.7%) by laboratory criterion, 4,920 (2.3%) by clinical and epidemiological criteria, 660 (0.3%) by clinical-imaging criterion and 1,144 (0.5%) by clinical criterion, 160,855 (25.5%) were discarded and 225,955 (35.9%) continue as suspects


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Pandemias , Betacoronavirus , Brasil/epidemiologia , Incidência , Infecções por Coronavirus/mortalidade , Monitoramento Epidemiológico
8.
Goiânia; s.n; Out. 14, 2020. ilus, tab, mapas, graf.(Boletim Epidemiológico Covid-19, 28).
Monografia em Português | Coleciona SUS, CONASS, SES-GO | ID: biblio-1123103

RESUMO

Esta edição do Boletim Epidemiológico COVID19 apresenta um panorama geral desde os primeiros registros na China em dezembro de 2019 até o dia 10 de outubro foram confirmados 37.109.851 casos de COVID-19 no mundo. Deste total, 1.070.355 evoluíram a óbito. Quando comparados o número de casos e óbitos confirmados desta semana epidemiológica (SE 41) com a semana anterior, houve aumento de 6,6% nos casos e 3,8% nos óbitos. No Brasil, neste mesmo intervalo de tempo, o aumento foi 3,6% e 2,7% no número de casos e óbitos, respectivamente. No país o primeiro caso foi confirmado no dia 26 de fevereiro e até 10 de outubro foram registrados 5.103.408 casos confirmados com 150.689 óbitos. Apresenta os dados referentes a situação epidemiológica COVID-19 no período de 02 de fevereiro a 10 de outubro de 2020 no Estado de Goiás, Brasil, informando que o registro dos primeiros casos suspeitos em Goiás foi a partir de 04 de fevereiro e até 10 de outubro foram notificados à Vigilância Epidemiológica 656.938 casos de COVID-19. Nesta última semana epidemiológica (SE 40) houve a confirmação de 12.721 casos novos, representando um aumento de 5,9%, superior ao aumento observado no Brasil 3,6%. No Estado, 228.717 (34,8%) foram confirmados sendo 220.473 (96,4%) por critério laboratorial, 5.565 (2,4%) pelo critério clínico-epidemiológico, 780 (0,3%) por critério clínico-imagem e 1.393 (0,6%) pelo critério clínico, 168.061 (25,6%) foram descartados e 228.443 (34,8%) continuam como suspeitos


This edition of the EPIDEMIOLOGICAL BULLETIN COVID19 presents an overview from the first records in China in December 2019 to October 10, 37,109,851 cases of COVID-19 worldwide were confirmed. Of this total, 1,070,355 died. When comparing the number of confirmed cases and deaths of this epidemiological week (SE 41) with the previous week, there was an increase of 6.6% in cases and 3.8% in deaths. In Brazil, in this same time interval, the increase was 3.6% and 2.7% in the number of cases and deaths, respectively. In the country the first case was confirmed on February 26 and until October 10, 5,103,408 confirmed cases with 150,689 deaths were recorded. It presents data regarding the epidemiological situation COVID-19 from February 2 to October 10, 2020 in the State of Goiás, Brazil, stating that the registration of the first suspected cases in Goiás was from February 4 and until October 10, 656,938 cases of COVID-19 were reported to epidemiological surveillance. In this last epidemiological week (SE 40) there was the confirmation of 12,721 new cases, representing an increase of 5.9%, higher than the increase observed in Brazil 3.6%. In the State, 228,717 (34.8%) were confirmed to be 220,473 (96.4%) by laboratory criterion, 5,565 (2.4%) by clinical and epidemiological criteria, 780 (0.3%) by clinical-imaging criterion and 1,393 (0.6%) by clinical criterion, 168,061 (25.6%) were discarded and 228,443 (34.8%) continue as suspects


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Adulto Jovem , Pneumonia Viral/epidemiologia , Infecções por Coronavirus/epidemiologia , Pandemias , Betacoronavirus , Pneumonia Viral/diagnóstico , Pneumonia Viral/mortalidade , Brasil/epidemiologia , Incidência , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Monitoramento Epidemiológico
9.
J Indian Soc Pedod Prev Dent ; 38(3): 232-237, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33004720

RESUMO

Background: Dental trauma can determine the occurrence of sequelae in the deciduous tooth and due to the anatomical proximity to the germ of the successor permanent tooth, it frequently causes changes to the developing teeth. Aims: The objective of this study was to analyze clinically and radiographically traumatized primary teeth and permanent successors in children aged 0-8 years. Materials and Methods: Initially, a sample selection of medical records was made, designating the patients who fit the requirements; 247 patients were analyzed, totaling 379 traumatized primary teeth and 162 successive permanent teeth. Statistical Analysis: The results were developed using the Proportion Test and the Chi-square test at the 5% significance level. Results: Injuries to hard tissue prevailed (57%), with emphasis on coronary enamel fracture (49.1%). After clinical and radiographic examinations, 78% of traumatized primary teeth maintained pulpal vitality. At the clinical evaluation, the frequency of the developmental disorders observed in permanent successors was 10.5%, with enamel hypocalcification being the most common sequela. 17.3% of the clinical changes in the successor permanent teeth were caused by trauma to the supporting tissue, with the intrusive dislocation being responsible for the largest number of damages (37.5%). Conclusion: Based on the results found, it was concluded that the trauma occurring in the primary dentition were recorded and monitored more precisely and about the evaluated successive permanent teeth, except for the prevalence of sequelae found, the other factors are in agreement with the findings in the literature.


Assuntos
Hipoplasia do Esmalte Dentário , Avulsão Dentária , Criança , Pré-Escolar , Dentição Permanente , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Dente Decíduo
10.
J Indian Soc Pedod Prev Dent ; 38(3): 274-279, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33004726

RESUMO

Background: Parental acceptance of behavior management techniques (BMTs) in dental practice is important and subjected to change with the dynamics of the society. Aims: The aim of this study was to evaluate the parental acceptance of eight selected BMTs: tell-show-do (TSD), voice control (VC), passive restraint (PR), active restraint (AR), parental presence/absence (PP/PA), oral sedation (OS), inhalation sedation nitrous oxide/oxygen (N2O/O2), and general anesthesia (GA) and its associated factors in a group of Thai parents. Design: The cross-sectional study was conducted among 200 parents of preschool children in Bangkok metropolitan. Materials and Methods: Parents were asked to rate the BMTs demonstrated in video with a Visual Analog Scale (VAS). Possible relevant factors were collected via questionnaires. Descriptive statistics were used to describe the samples. BMTs were ranked by mean VAS using the general linear model repeated measure. The association between the mean VASs and parental and child's factors was analyzed using the one-way ANOVA and independent t-test. Significant factors were further analyzed by multiple linear regression. The level of confidence was set at 95%. Results: All BMTs were acceptable. TSD was rated the highest, followed by PR, VC, AR, N2O/O2, OS, GA, and PP/PA, respectively. Parental dental anxiety was associated with less acceptance of PP/PA. Child's experience of VC, AR, OS, and PP/PA was related to better acceptance of the techniques. Conclusions: The BMTs were better accepted with similar pattern compared to past studies. PP/PA was the least accepted related to high parental anxiety. Child's experience with BMTs increased the acceptance.


Assuntos
Comportamento Infantil , Pais , Terapia Comportamental , Criança , Pré-Escolar , Estudos Transversais , Humanos , Tailândia
11.
J Indian Soc Pedod Prev Dent ; 38(3): 304-310, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33004730

RESUMO

Background: Despite endodontic infections being a common problem in the primary dentition, some of the infected primary teeth can remain functional until the exfoliation through endodontic treatment. The primary endodontic treatment goal must be to optimize root canal disinfection and to prevent reinfection. Aim: The aim of this study is to compare the antifungal efficacy of antimicrobial photodynamic therapy, LASER, and 1% clotrimazole as irrigants by reducing the colony-forming units (CFU) of Candida albicans in the infected root canals of primary teeth. Materials and Methods: Pulp therapy was performed on deciduous mandibular second molars of 20 healthy children aged 5-8 years, which were divided into four groups of intracanal disinfection protocols: Group 1 (n = 5) - Sodium Hypochlorite, Group 2 (n = 5) - Photodynamic, Group 3 (n = 5) - Normal saline with LASER, and Group 4 - (n = 5) Antifungal. Disinfection potential was compared by collecting samples one just after access opening and the other after the experimental groups using paper points. The samples were cultured and incubated for 48 h to check change in CFU of the fungi. Results: Data were analyzed statistically using the Shapiro-Wilk's test, Mann-Whitney U-test; Kruskal-Wallis test, and Wilcoxon signed-ranks test. No significant difference (P > 0.05) was found between the different groups. However, complete inhibition of C. albicans CFU was seen with Group 4. Conclusion: One percent Clotrimazole (antifungal) can be utilized as an adjunct in the endodontic irrigation protocol for better success of pulpectomy in children.


Assuntos
Anti-Infecciosos , Fotoquimioterapia , Antifúngicos , Candida albicans , Criança , Pré-Escolar , Cavidade Pulpar , Desinfecção , Humanos , Projetos Piloto , Irrigantes do Canal Radicular/uso terapêutico , Preparo de Canal Radicular , Dente Decíduo
12.
Lancet Respir Med ; 8(10): 975-986, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33007285

RESUMO

BACKGROUND: Chronic pulmonary infection with Pseudomonas aeruginosa is one of the most important causes of mortality and morbidity in cystic fibrosis. If antibiotics are commenced promptly, infection can be eradicated. The aim of the trial was to compare the effectiveness and safety of intravenous ceftazidime and tobramycin versus oral ciprofloxacin in the eradication of P aeruginosa. METHODS: We did a multicentre, parallel group, open-label, randomised controlled trial in 72 cystic fibrosis centres (70 in the UK and two in Italy). Eligible participants were older than 28 days with an isolate of P aeruginosa (either the first ever isolate or a new isolate after at least 1 year free of infection). Participants were excluded if the P aeruginosa was resistant to, or they had a contraindication to, one or more of the trial antibiotics; if they were already receiving P aeruginosa suppressive therapy; if they had received any P aeruginosa eradication therapy within the previous 9 months; or if they were pregnant or breastfeeding. We used web-based randomisation to assign patients to 14 days intravenous ceftazidime and tobramycin or 12 weeks oral ciprofloxacin. Both were combined with 12 weeks inhaled colistimethate sodium. Randomisation lists were generated by a statistician, who had no involvement in the trial, using a computer-generated list. Randomisation was stratified by centre and because of the nature of the interventions, blinding was not possible. Our primary outcome was eradication of P aeruginosa at 3 months and remaining free of infection to 15 months. Primary analysis used intention to treat (powered for superiority). Safety analysis included patients who received at least one dose of study drug. TORPEDO-CF was registered on the ISRCTN register, ISRCTN02734162, and EudraCT, 2009-012575-10. FINDINGS: Between Oct 5, 2010, and Jan 27, 2017, 286 patients were randomly assigned to treatment: 137 to intravenous antibiotics and 149 to oral antibiotics. 55 (44%) of 125 participants in the intravenous group and 68 (52%) of 130 participants in the oral group achieved the primary outcome. Participants randomly assigned to the intravenous group were less likely to achieve the primary outcome, although the difference between groups was not statistically significant (relative risk 0·84, 95% CI 0·65-1·09; p=0·18). 11 serious adverse events occurred in ten (8%) of 126 participants in the intravenous antibiotics group and 17 serious adverse events in 12 (8%) of 146 participants in the oral antibiotics group. INTERPRETATION: Compared with oral therapy, intravenous antibiotics did not achieve sustained eradication of P aeruginosa in a greater proportion of patients with cystic fibrosis and was more expensive. Although there were fewer hospitalisations in the intravenous group than the oral group during follow-up, this confers no advantage over oral treatment because intravenous eradication frequently requires hospitalisation. These results do not support the use of intravenous antibiotics to eradicate P aeruginosa in cystic fibrosis. FUNDING: National Institute for Health Research Health Technology Assessment Programme.


Assuntos
Antibacterianos/administração & dosagem , Ceftazidima/administração & dosagem , Fibrose Cística/microbiologia , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa , Tobramicina/administração & dosagem , Administração Intravenosa , Administração Oral , Adolescente , Adulto , Criança , Pré-Escolar , Fibrose Cística/tratamento farmacológico , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Infecções por Pseudomonas/complicações , Resultado do Tratamento , Adulto Jovem
14.
Ann Emerg Med ; 76(4): 413-426, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33012377

RESUMO

STUDY OBJECTIVE: Emergency medical services (EMS) may serve as a key source of real-time data about the evolving health of coronavirus disease 2019 (COVID-19)-affected populations, especially in low- and middle-income countries with less rapid and reliable vital statistics registration systems. Although official COVID-19 statistics in Mexico report almost exclusively inhospital mortality events, excess out-of-hospital mortality has been identified in other countries, including 1 EMS study in Italy that showed a 58% increase. Additionally, EMS and hospital reports from several countries have suggested that silent hypoxemia-low Spo2 in the absence of dyspnea-is associated with COVID-19. It is unclear, however, how these phenomena can be generalized to low- and middle-income countries. We assess how EMS data can be used in a sentinel capacity in Tijuana, a city on the Mexico-United States border with earlier exposure to COVID-19 than many low- and middle-income country settings. METHODS: In this observational study, we calculated numbers of weekly out-of-hospital deaths and respiratory cases handled by EMS in Tijuana, and estimated the difference between peak epidemic rates and expected trends based on data from 2014 to 2019. Results were compared with official COVID-19 statistics, stratified by neighborhood socioeconomic status, and examined for changing demographic or clinical features, including mean Spo2. RESULTS: An estimated 194.7 excess out-of-hospital deaths (95% confidence interval 135.5 to 253.9 deaths) occurred during the peak window (April 14 to May 11), representing an increase of 145% (95% CI 70% to 338%) compared with expected levels. During the same window, only 5 COVID-19-related out-of-hospital deaths were reported in official statistics. This corresponded with an increase in respiratory cases of 236.5% (95% CI 100.7% to 940.0%) and a decrease in mean Spo2 to 77.7% from 90.2% at baseline. The highest out-of-hospital death rates were observed in low-socioeconomic-status areas, although respiratory cases were more concentrated in high-socioeconomic-status areas. CONCLUSION: EMS systems may play an important sentinel role in monitoring excess out-of-hospital mortality and other trends during the COVID-19 crisis in low- and middle-income countries. Using EMS data, we observed increases in out-of-hospital deaths in Tijuana that were nearly 3-fold greater than increases reported in EMS data in Italy. Increased testing in out-of-hospital settings may be required to determine whether excess mortality is being driven by COVID-19 infection, health system saturation, or patient avoidance of health care. We also found evidence of worsening rates of hypoxemia among respiratory patients treated by EMS, suggesting a possible increase in silent hypoxemia, which should be met with increased detection and clinical management efforts. Finally, we observed social disparities in out-of-hospital death that warrant monitoring and amelioration.


Assuntos
Infecções por Coronavirus/complicações , Infecções por Coronavirus/mortalidade , Serviços Médicos de Emergência/estatística & dados numéricos , Hipóxia/virologia , Pneumonia Viral/complicações , Pneumonia Viral/mortalidade , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Criança , Pré-Escolar , Registros Eletrônicos de Saúde , Feminino , Humanos , Lactente , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Pandemias , Vigilância em Saúde Pública , Classe Social , Adulto Jovem
16.
Rev Saude Publica ; 54: 90, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33027343

RESUMO

OBJECTIVE: To analyze factors associated with diarrheal disease in the rural Caribbean region of Colombia. METHOD: A cross-sectional study conducted in the rural area of the Cesar Department, Colombia, between November 2017 and June 2018. Self-reported cases of diarrheal disease were surveyed, and water samples from 42 households were collected and analyzed. Descriptive statistics were employed in the analysis of socioeconomic status, environmental and sanitary conditions, and we evaluated their association with the diarrheal disease using the Poisson regression models. Each model was adjusted with variables suggested by specific directed acyclic graphs. RESULTS: Poor water supply conditions, hygiene and basic sanitation were reported in the study area. All water samples were classified either as high risk for health problems or unfit for human consumption. The diarrheal disease had a prevalence of 7.5% across all ages and of 23.5% in children under five years old. The variables rainy season (PR = 0.24; 95%CI 0.07-0.85), children under five years old (PR = 4.05; 95%CI 1.70-9.68), water from deep wells (PR = 16.90; 95%CI 2.45-116.67), water from artificial ponds (PR = 11.47; 95%CI 1.27-103.29), toilets availability (PRA = 0.23; 95%CI 0.06-0.96), and swine presence (PR = 0.20; 95%CI 0.05-0.74) were significantly associated with the occurrence of diarrheal disease. CONCLUSION: Water supply, hygiene and basic sanitation conditions have been associated with the diarrheal disease, affecting almost a quarter of the population under five years old. There is an urge for the design of effective policies that improve environmental and sanitation conditions in rural areas.


Assuntos
Diarreia/epidemiologia , População Rural/estatística & dados numéricos , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Colômbia/epidemiologia , Estudos Transversais , Inquéritos Epidemiológicos , Humanos , Lactente , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-33027392

RESUMO

Tuberculosis of the skull or calvarial tuberculosis (CTB) is rare. The literature until 2019 reported less than 60 cases of CTB in childhood. The authors describe two patients with CTB associated with other manifestations of TB, such as: spine and rib injuries, peripheral adenopathy, hepatic and splenic involvement who improved with chemotherapy. The patients were a four-year-old and an eight-year-old child, whose diagnoses were confirmed by histopathological, bacteriological or molecular investigation. Both were not infected with the human immunodeficiency virus (HIV) and did not need orthopedic treatment.


Assuntos
Crânio/diagnóstico por imagem , Teste Tuberculínico/métodos , Tuberculose/diagnóstico , Antituberculosos/uso terapêutico , Criança , Pré-Escolar , Humanos , Coluna Vertebral/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Tuberculose/tratamento farmacológico
19.
Nat Commun ; 11(1): 4965, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33009371

RESUMO

Next-generation sequencing (NGS) can identify novel cancer targets. However, interpreting the molecular findings and accessing drugs/clinical trials is challenging. Furthermore, many tumors show resistance to monotherapies. To implement a precision strategy, we initiated a multidisciplinary (basic/translational/clinical investigators, bioinformaticians, geneticists, and physicians from multiple specialties) molecular tumor board (MTB), which included a project manager to facilitate obtaining clinical-grade biomarkers (blood/tissue NGS, specific immunohistochemistry/RNA expression including for immune-biomarkers, per physician discretion) and medication-acquisition specialists/clinical trial coordinators/navigators to assist with medication access. The MTB comprehensively reviewed patient characteristics to develop N-of-One treatments implemented by the treating physician's direction under the auspices of a master protocol. Overall, 265/429 therapy-evaluable patients (62%) were matched to ≥1 recommended drug. Eighty-six patients (20%) matched to all drugs recommended by MTB, including combinatorial approaches, while 38% received physician's choice regimen, generally with unmatched approach/low degree of matching. Our results show that patients who receive MTB-recommended regimens (versus physician choice) have significantly longer progression-free (PFS) and overall survival (OS), and are better matched to therapy. High (≥50%) versus low (<50%) Matching Score therapy (roughly reflecting therapy matched to ≥50% versus <50% of alterations) independently correlates with longer PFS (hazard ratio [HR], 0.63; 95% confidence interval [CI], 0.50-0.80; P < 0.001) and OS (HR, 0.67; 95% CI, 0.50-0.90; P = 0.007) and higher stable disease ≥6 months/partial/complete remission rate (52.1% versus 30.4% P < 0.001) (all multivariate). In conclusion, patients who receive MTB-based therapy are better matched to their genomic alterations, and the degree of matching is an independent predictor of improved oncologic outcomes including survival.


Assuntos
Neoplasias/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/uso terapêutico , Criança , Pré-Escolar , DNA Tumoral Circulante/genética , Intervalo Livre de Doença , Feminino , Genoma Humano , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Medicina de Precisão , Resultado do Tratamento , Adulto Jovem
20.
MMWR Morb Mortal Wkly Rep ; 69(40): 1464-1468, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031360

RESUMO

Wild poliovirus type 1 (WPV1) transmission is ongoing only in Afghanistan and Pakistan (1). Following a decline in case numbers during 2013-2016, the number of cases in Afghanistan has increased each year during 2017-2020. This report describes polio eradication activities and progress toward polio eradication in Afghanistan during January 2019-July 2020 and updates previous reports (2,3). Since April 2018, insurgent groups have imposed bans on house-to-house vaccination. In September 2019, vaccination campaigns in areas under insurgency control were restarted only at health facilities. In addition, during March-June 2020, all campaigns were paused because of the coronavirus disease 2019 (COVID-19) pandemic. The number of WPV1 cases reported in Afghanistan increased from 21 in 2018 to 29 in 2019. During January-July 2020, 41 WPV1 cases were reported as of August 29, 2020 (compared with 15 during January-July 2019); in addition, 69 cases of circulating vaccine-derived poliovirus type 2 (cVDPV2), and one case of ambiguous vaccine-derived poliovirus type 2 (aVDPV2) (isolates with no evidence of person-to-person transmission or from persons with no known immunodeficiency) were detected. Dialogue with insurgency leaders through nongovernmental and international organizations is ongoing in an effort to recommence house-to-house campaigns, which are essential to stopping WPV1 transmission in Afghanistan. To increase community demand for polio vaccination, additional community health needs should be addressed, and polio vaccination should be integrated with humanitarian services.


Assuntos
Erradicação de Doenças , Poliomielite/prevenção & controle , Vigilância da População , Adolescente , Afeganistão/epidemiologia , Criança , Pré-Escolar , Humanos , Programas de Imunização , Esquemas de Imunização , Lactente , Poliomielite/epidemiologia , Poliovirus/isolamento & purificação , Vacina Antipólio Oral/administração & dosagem , Vacinação/estatística & dados numéricos
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