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1.
Medicine (Baltimore) ; 99(44): e22862, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126330

RESUMO

The aim of this study was to assess the levels of self-perceived burden (SPB) and self-management behavior in elderly stroke survivors during the first 3 months after acute stroke, and to explore the correlation between them.A total of 203 consecutive hospitalized elderly patients diagnosed with stroke were recruited. Self-perceived Burden Scale and Stroke Self-management Scale in 1 month (T1) and 3 months (T2) post-stroke were assessed and compared.The score of SPB in elderly stroke survivors was 28.96 ±â€Š5.50 and 27.25 ±â€Š6.17 at T1 and T2, respectively. Stroke self-management scale scored 165.93 ±â€Š9.82 at T1 and 167.29 ±â€Š10.60 at T2. In the first 3 months post-stroke, the physical burden was dominant (T1 14.73 ±â€Š3.07, T2 14.40 ±â€Š3.13), and the behavior of stroke symptoms and signs monitoring (T1 27.58 ±â€Š6.56, T2 28.64 ±â€Š6.43) and rehabilitation exercise management (T1 21.40 ±â€Š3.28, T2 20.74 ±â€Š3.15) was the worst. SPB was negatively correlated with self-management behavior (T1 r = -.202, T2 r = -.511).Elderly stroke survivors experienced a medium level of SPB and self-management behavior in the first 3 months post-stroke. There is a positive relationship between reduced SPB and improved self-management behavior. Addressing the characteristics and correlations as well as development of targeted interventions for SPB decreasing is beneficial to improving self-management behavior for elderly survivors.


Assuntos
Efeitos Psicossociais da Doença , Autoimagem , Autogestão/psicologia , Reabilitação do Acidente Vascular Cerebral/psicologia , Idoso , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicometria/métodos , Autogestão/métodos , Autogestão/estatística & dados numéricos , Acidente Vascular Cerebral/psicologia , Acidente Vascular Cerebral/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Reabilitação do Acidente Vascular Cerebral/estatística & dados numéricos , Sobreviventes/psicologia , Sobreviventes/estatística & dados numéricos
3.
Cent Eur J Public Health ; 28(3): 237-244, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32997481

RESUMO

OBJECTIVE: Period of elderly age preordains the occurrence of many health issues. People deported during World War II to concentration camps suffered from malnutrition, lack of sleep, physical and mental exhaustion. Recently, the health condition of Holocaust survivors is often complicated as a result of physical punishments and different torture methods as well as mental hardships which they had suffered during deportation. The consequences often have psychosomatic nature thus the survivors are often receivers of health care. The topic of bibliography review is based on the need to objectivize and systematically evaluate subjective health issues of Holocaust survivors in connection with trauma related to the stay in a concentration camp. The aim is to offer a review of effects of the Holocaust on health of different body systems for survivors in concentration camps and Jewish ghettos in the course of World War II. METHODS: To map the subjective problems of Holocaust survivors, evidence-based medicine (EBM) method has been used with the help of scientific database PubMed, CINAHL Plus with full text, ProQuest and other sources with specific key words and Boole operators. Prognostic type of clinical/review questions has been selected for the bibliography review, which is trying to predict the probability of relation or output of illness/condition and based on diseases or symptoms seriousness to find out expectancy for treatment/improvement of care. RESULTS: 175 studies have been found in basic search with the use of key words both in English and in Czech language. The search has not been time-limited. The advanced search has focused on different body systems and health damage due to Nazi experiments. Fourteen studies have been used to complete the study. The research results have confirmed the significant effect of Holocaust trauma on body condition of the survivors. The reasons of this condition were insufficient nutrition, unsuitable and harmful hygienic, living and working conditions and brutality of the guards. According to the research, these factors have impacted all organ systems, mainly locomotion and cardiovascular ones. The results have shown a more frequent occurrence of osteoporosis, fractures of long bones and corresponding chronical pain of people of Jewish origin who had gone through different forms of torture during World War II. Other present symptoms include gastrointestinal problems, tumors mainly in the area of colorectum and lungs. Moreover, the stay in concentration camps had influence on women's menstrual cycle. CONCLUSION: The studies of Holocaust effects are an example of the influence of an extreme mental and physical burden on the body condition of the survivors' health. The results of the studies have shown a wide range of the effects also in mental and social areas.


Assuntos
Nível de Saúde , Holocausto , Sobreviventes/estatística & dados numéricos , Bibliografias como Assunto , Humanos , Judeus
5.
J Psychiatr Res ; 129: 98-102, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32912598

RESUMO

This study aims to evaluate the impacts of COVID-19 on cognitive functions in recovered patients and its relationship with inflammatory profiles. Twenty-nine patients recovered from COVID-19 as confirmed by negative nucleic tests for two consecutive times were recruited. A total of 29 age-, gender- and education-matched healthy controls were also recruited. The cognitive functions of all subjects were evaluated by the iPad-based online neuropsychological tests, including the Trail Making Test (TMT), Sign Coding Test (SCT), Continuous Performance Test (CPT), and Digital Span Test (DST). Blood samples from all patients were collected for examining inflammatory profiles, including interleukin-2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and C-reactive protein (CRP). The relationship between cognitive functions and inflammatory profiles were analyzed by Pearson correlation. In results, although no significant differences were found in TMT, SCT, and DST between the two groups, patients with COVID-19 scored lower in the correct number of the second and third parts of CPT, they also scored higher in the missing number of the third part of CPT (all P < 0.05). In patients with COVID-19, there was a trend of significant difference for lower reaction time in the first and second parts of CPT (P = 0.050, and 0.051, respectively), as well as the lower correct number of the second part of CPT (P = 0.050). Correlation analysis showed that the reaction time for the first and second parts of CPT was positively correlated with the CRP levels (r = 0.557 and 0.410, P < 0.05). In conclusion, our findings indicated that cognitive impairments exist even in patients recovered from COVID-19, and might be possibly linked to the underlying inflammatory processes.


Assuntos
Betacoronavirus , Disfunção Cognitiva/complicações , Infecções por Coronavirus/complicações , Inflamação/complicações , Pneumonia Viral/complicações , Sobreviventes/estatística & dados numéricos , Adulto , Disfunção Cognitiva/diagnóstico , Infecções por Coronavirus/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos/estatística & dados numéricos , Pandemias , Pneumonia Viral/psicologia
7.
Am J Cardiol ; 135: 50-61, 2020 11 15.
Artigo em Inglês | MEDLINE | ID: mdl-32916148

RESUMO

Since the emergence of the coronavirus disease 19 (COVID-19), a number of studies have reported the presence of cardiovascular diseases in affected patients and linked them with a higher risk of mortality. We conducted an online search in Medline/PubMed to identify original cohorts comparing data between survivors and non-survivors from COVID-19. The presence of cardiovascular events and related biomarkers were compared between the 2 groups. Data on 1,845 hospitalized patients with COVID-19 were pooled from 12 comparative studies. The overall mortality rate in relation to COVID-19 was 17.6%. Men aged > 50 years old were more likely to die from COVID-19. Significant co-morbidities contributing to mortality were hypertension, diabetes mellitus, smoking, a previous history of cardiovascular disease including chronic heart failure, and cerebrovascular accidents. A significant relationship was observed between mortality and patient presentation with dyspnea, fatigue, tachycardia, and hypoxemia. Cardiovascular disease-related laboratory biomarkers related to mortality were elevated serum level of lactate dehydrogenase, creatine kinase, brain natriuretic peptide, and cardiac troponin I. Adverse cardiovascular disease-related clinical events preceding death were shock, arrhythmias, and acute myocardial injury. In conclusion, severe clinical presentation and elevated biomarkers in COVID-19 patients with established risk factors can predict mortality from cardiovascular causes.


Assuntos
Doenças Cardiovasculares/epidemiologia , Causas de Morte , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Sobreviventes/estatística & dados numéricos , Troponina I/sangue , Fatores Etários , Idoso , Biomarcadores/sangue , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/terapia , China/epidemiologia , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Fatores Sexuais , Análise de Sobrevida
8.
Brain Behav Immun ; 89: 594-600, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32738287

RESUMO

Infection-triggered perturbation of the immune system could induce psychopathology, and psychiatric sequelae were observed after previous coronavirus outbreaks. The spreading of the Severe Acute Respiratory Syndrome Coronavirus (COVID-19) pandemic could be associated with psychiatric implications. We investigated the psychopathological impact of COVID-19 in survivors, also considering the effect of clinical and inflammatory predictors. We screened for psychiatric symptoms 402 adults surviving COVID-19 (265 male, mean age 58), at one month follow-up after hospital treatment. A clinical interview and a battery of self-report questionnaires were used to investigate post-traumatic stress disorder (PTSD), depression, anxiety, insomnia, and obsessive-compulsive (OC) symptomatology. We collected sociodemographic information, clinical data, baseline inflammatory markers and follow-up oxygen saturation levels. A significant proportion of patients self-rated in the psychopathological range: 28% for PTSD, 31% for depression, 42% for anxiety, 20% for OC symptoms, and 40% for insomnia. Overall, 56% scored in the pathological range in at least one clinical dimension. Despite significantly lower levels of baseline inflammatory markers, females suffered more for both anxiety and depression. Patients with a positive previous psychiatric diagnosis showed increased scores on most psychopathological measures, with similar baseline inflammation. Baseline systemic immune-inflammation index (SII), which reflects the immune response and systemic inflammation based on peripheral lymphocyte, neutrophil, and platelet counts, positively associated with scores of depression and anxiety at follow-up. PTSD, major depression, and anxiety, are all high-burden non-communicable conditions associated with years of life lived with disability. Considering the alarming impact of COVID-19 infection on mental health, the current insights on inflammation in psychiatry, and the present observation of worse inflammation leading to worse depression, we recommend to assess psychopathology of COVID-19 survivors and to deepen research on inflammatory biomarkers, in order to diagnose and treat emergent psychiatric conditions.


Assuntos
Transtornos de Ansiedade/epidemiologia , Infecções por Coronavirus/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Pneumonia Viral/epidemiologia , Sobreviventes/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Ansiedade/epidemiologia , Ansiedade/imunologia , Ansiedade/psicologia , Transtornos de Ansiedade/imunologia , Transtornos de Ansiedade/psicologia , Betacoronavirus , Proteína C-Reativa/imunologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Depressão/imunologia , Depressão/psicologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/imunologia , Transtorno Depressivo/psicologia , Transtorno Depressivo Maior/imunologia , Transtorno Depressivo Maior/psicologia , Serviço Hospitalar de Emergência , Feminino , Humanos , Inflamação , Itália/epidemiologia , Tempo de Internação/estatística & dados numéricos , Contagem de Leucócitos , Contagem de Linfócitos , Masculino , Transtornos Mentais/epidemiologia , Transtornos Mentais/imunologia , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Monócitos , Neutrófilos , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/imunologia , Transtorno Obsessivo-Compulsivo/psicologia , Pandemias , Pneumonia Viral/imunologia , Pneumonia Viral/psicologia , Índice de Gravidade de Doença , Fatores Sexuais , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/imunologia , Distúrbios do Início e da Manutenção do Sono/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/imunologia , Transtornos de Estresse Pós-Traumáticos/psicologia
10.
Pulm Med ; 2020: 6175964, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32850151

RESUMO

Although pulmonary fibrosis can occur in the absence of a clear-cut inciting agent, and without a clinically clear initial acute inflammatory phase, it is more commonly associated with severe lung injury. This may be due to respiratory infections, chronic granulomatous diseases, medications, and connective tissue disorders. Pulmonary fibrosis is associated with permanent pulmonary architectural distortion and irreversible lung dysfunction. Available clinical, radiographic, and autopsy data has indicated that pulmonary fibrosis is central to severe acute respiratory distress syndrome (SARS) and MERS pathology, and current evidence suggests that pulmonary fibrosis could also complicate infection by SARS-CoV-2. The aim of this review is to explore the current literature on the pathogenesis of lung injury in COVID-19 infection. We evaluate the evidence in support of the putative risk factors for the development of lung fibrosis in the disease and propose risk mitigation strategies. We conclude that, from the available literature, the predictors of pulmonary fibrosis in COVID-19 infection are advanced age, illness severity, length of ICU stay and mechanical ventilation, smoking and chronic alcoholism. With no proven effective targeted therapy against pulmonary fibrosis, risk reduction measures should be directed at limiting the severity of the disease and protecting the lungs from other incidental injuries.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Fibrose Pulmonar/complicações , Comportamento de Redução do Risco , Sobreviventes/estatística & dados numéricos , Fatores Etários , Alcoolismo/complicações , Humanos , Tempo de Internação/estatística & dados numéricos , Pandemias , Respiração Artificial/efeitos adversos , Respiração Artificial/estatística & dados numéricos , Índice de Gravidade de Doença , Tabagismo/complicações
11.
Am J Geriatr Psychiatry ; 28(10): 1030-1039, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32753338

RESUMO

OBJECTIVE: To examine the psychological distress and the associated predictor factors of the 2019 corona-virus disease (COVID-19) on survivors in the early convalescence in Shenzhen. METHOD: A survey questionnaire consisting of post-traumatic stress disorder self-rating scale (PTSD-SS), self-rating depression scale (SDS), and self-rating anxiety scale (SAS) was presented to COVID-19 survivors still in quarantine. Scores of each scale and subscale were dependent variables in the Mann-Whitney test and stepwise regression analysis. RESULTS: A total of 126 subjects were included in the study, the mean scores of PTSD-SS, SDS, and SAS were 45.5 ± 18.9, 47.3 ± 13.1, and 43.2 ± 10.2, respectively, meanwhile, 9 (31.0%), 28 (22.2%), and 48 (38.1%) of the survivors met the cut-score for clinical significant symptoms of stress response, anxiety, and depression, respectively. Infected family members, and postinfection physical discomforts were significantly associated with scores on all three scales. Social support, retirement, and being female had significant associations with the PTSD-SS score. The survivors aged 60 or above experienced less severe stress response symptoms, fewer emotional symptoms of depression, and fewer anxiety symptoms than younger survivors. CONCLUSION: The occurrence rate of psychological distress among the COVID-19 survivors in early convalescence was high, highlighting the need for all COVID-19 survivors to be screened for psychological distress regularly for timely intervention. The predictors indicated by the current study may help to identify those at high-risk. Besides, the results indicated the older survivors suffered less emotional reactivity and fewer stress response symptoms from infectious diseases than the younger ones.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Pneumonia Viral/psicologia , Aposentadoria/estatística & dados numéricos , Apoio Social , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Estresse Psicológico/epidemiologia , Sobreviventes/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Ansiedade/psicologia , Betacoronavirus , China/epidemiologia , Convalescença , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Depressão/psicologia , Emprego/estatística & dados numéricos , Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Fatores de Proteção , Angústia Psicológica , Fatores de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia , Sobreviventes/psicologia
12.
Pediatrics ; 146(3)2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32788267

RESUMO

CONTEXT: The International Liaison Committee on Resuscitation Neonatal Life Support Task Force reviewed evidence for the duration of cardiopulmonary resuscitation (CPR) for newborns immediately after birth. OBJECTIVE: To summarize evidence for ongoing CPR on the outcomes of survival, neurodevelopment, and the composite of survival without moderate or severe neurodevelopmental impairment (NDI). DATA SOURCES: Medline, Embase, Evidence-Based Medicine Reviews, Cumulative Index to Nursing and Allied Health Literature, and Scientific Electronic Library Online were searched between inception and February 29, 2020. STUDY SELECTION: Two independent reviewers selected studies of newborns with at least 10 minutes of asystole, bradycardia, or pulseless electrical activity for which CPR is indicated. DATA EXTRACTION: Two independent reviewers extracted data and appraised the risk of bias. RESULTS: In 16 eligible studies, researchers reported outcomes of 579 newborns born between 1982 and 2017. Within individual studies, 2% to 100% of infants survived to last follow-up (hospital discharge through 12 years). Summarized across studies, 237 of 579 (40.9%) newborns survived to last follow-up. In 13 studies, researchers reported neurodevelopmental outcomes of 277 newborns. Of these, 30 of 277 (10.8%) survived without moderate or severe impairment, and 240 of 277 (87%) met the composite outcome of death or NDI (191 died and 49 survived with moderate or severe impairment). LIMITATIONS: There was very low certainty of evidence because of risk of bias and inconsistency. CONCLUSIONS: Infants with ongoing CPR at 10 minutes after birth are at high risk for mortality and neurodisability, but survival without moderate or severe NDI is possible. One specified duration of CPR is unlikely to uniformly predict survival or survival without neuroimpairment.


Assuntos
Bradicardia/terapia , Reanimação Cardiopulmonar/estatística & dados numéricos , Desenvolvimento Infantil , Parada Cardíaca/terapia , Transtornos do Neurodesenvolvimento/epidemiologia , Comitês Consultivos , Viés , Frequência Cardíaca , Humanos , Recém-Nascido , Transtornos do Neurodesenvolvimento/mortalidade , Sobreviventes/estatística & dados numéricos , Fatores de Tempo
13.
Health Qual Life Outcomes ; 18(1): 229, 2020 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-32664966

RESUMO

BACKGROUND: The aim of this longitudinal study was to identify risk factors for posttraumatic stress disorder (PTSD) in inpatients injured in the Ludian earthquake and examine the relationship between PTSD symptoms and health-related quality of life (HRQoL) following the earthquake. METHODS: Three assessments were performed during an 18-month follow-up period. In total, one-hundred forty-seven inpatients of one-hundred seventy-four inpatients (85% of the initial sample) underwent all the assessments. Injured inpatients admitted to the No. 1 People's Hospital of Zhaotong City after a severe earthquake (6.5 on the Richter scale) were enrolled in the study and assessed using the Posttraumatic Stress Disorder Checklist-Civilian Version, Clinician-Administered Posttraumatic Stress Disorder Scale, and Medical Outcomes Study Short Form-36 Scale. RESULTS: At the first, third and eighteenth months after the earthquake, the prevalence rates for PTSD were 23, 14, and 7%, respectively. In a regression model, bereavement, history of major diseases, and severe injury in the earthquake were associated with severe PTSD symptoms. HRQoL was negatively correlated with PTSD symptoms. Compared to that of Chinese norms, participants' HRQoL was significantly lower in all eight HRQoL domains of the Medical Outcomes Study Short Form-36 Scale. CONCLUSIONS: The findings suggest that a substantial proportion of inpatients injured in the earthquake experienced severe PTSD symptoms and poor HRQoL. Therefore, early preventive programs and interventions should be implemented following disasters, to reduce PTSD and improve HRQoL in injured individuals.


Assuntos
Grupo com Ancestrais do Continente Asiático/psicologia , Terremotos/estatística & dados numéricos , Pacientes Internados/psicologia , Qualidade de Vida/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Sobreviventes/psicologia , Adulto , Grupo com Ancestrais do Continente Asiático/estatística & dados numéricos , China , Desastres/estatística & dados numéricos , Feminino , Humanos , Pacientes Internados/estatística & dados numéricos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Sobreviventes/estatística & dados numéricos
14.
Am J Ophthalmol ; 218: 268-278, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32621897

RESUMO

PURPOSE: Despite well-known ocular complications of HIV-related immune suppression, few studies have examined the prevalence and consequences of visual impairment among aging long-term survivors of HIV. DESIGN: Retrospective cohort study. METHODS: Aging HIV-infected (HIV+) men who have sex with men (MSM) and HIV-uninfected (HIV-) MSM controls reported their difficulty performing 6 vision-dependent tasks (difficulty defined as: no, a little, moderate, and extreme difficulty). Relationships were examined using logistic regression, regressing each outcome separately on categorical visual function responses, with missing data multiply imputed. RESULTS: There were 634 age-matched pairs for a total sample of 1,268 MSM of 1,700 MSM with available data. The median age was 60 years old (interquartile range [IQR], 54, 66), and 23% were African American. Among HIV+ men, 95% were virally suppressed (viral load <400 copies/mL). HIV+ men were more likely to report moderate or extreme difficulty performing at least 1 task (21% for HIV+ compared to 13% for HIV-; P < .01). Participants reporting extreme vision-related difficulty performing at least 1 task had 11.2 times the odds of frailty (95% confidence interval [CI], 5.2-23.9), 2.6 times the odds of a slow gait speed (95% CI, 1.4-4.8), and 3.2 times the odds of impaired instrumental activities of daily living (95% CI: 1.6-6.3) compared to those reporting no vision-related difficulty on any task. CONCLUSIONS: Perceived vision difficulty was more common among older HIV+ MSM than age-matched HIV- MSM controls and was associated with higher risk of depression and physical function loss among MSM.


Assuntos
Envelhecimento/fisiologia , Infecções por HIV/epidemiologia , Sobreviventes/estatística & dados numéricos , Transtornos da Visão/epidemiologia , Pessoas com Deficiência Visual/estatística & dados numéricos , Idoso , Estudos Transversais , HIV/genética , Infecções por HIV/diagnóstico , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Prevalência , RNA Viral/sangue , Estudos Retrospectivos , Perfil de Impacto da Doença , Inquéritos e Questionários , Carga Viral , Transtornos da Visão/diagnóstico
15.
Medicine (Baltimore) ; 99(29): e21050, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702847

RESUMO

The ability of sepsis to induce acute phase hearing impairment has been evaluated in septic and sepsis-surviving mice. The relationship between septicemia and long-term hearing impairment remains unknown in humans.The data were obtained from the Taiwan Longitudinal National Health Insurance Database from 2000 to 2013. We identified patients suffering from septicemia after discharge, excluding those younger than 18 years old and older than 65 years old. The comparison group was matched based on age, sex, and comorbidities. The outcome was hearing impairment occurring after septicemia. The risk factors associated with hearing impairment were established using multivariate Cox proportional hazard regression.Our study found that septicemia associated with hearing impairment had an adjusted hazard ratio (HR) of 53.11 (95% confidence interval [CI]: 41.74-67.59). The other factors related to hearing impairment in young and middle-aged septicemia survivors included male sex (adjusted HR 1.31 [95% CI: 1.14-1.5]), chronic kidney disease (adjusted HR 1.63 [95% CI: 1.38-1.94]), and otoscleroisis (adjusted HR 231.54 [95% CI: 31.61-1695.8]).Our study revealed that septicemia was associated with increased development of hearing impairment in young and middle-aged humans in the long term. Clinicians should be aware of long-term septicemia-related hearing impairment and provide prevention strategies for otopathy in septicemia survivors.


Assuntos
Pessoas com Deficiência Auditiva/estatística & dados numéricos , Sepse/complicações , Sobreviventes/estatística & dados numéricos , Adolescente , Adulto , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pessoas com Deficiência Auditiva/reabilitação , Modelos de Riscos Proporcionais , Fatores de Risco , Sepse/epidemiologia , Taiwan/epidemiologia
16.
Crit Care Med ; 48(8): e657-e665, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32697506

RESUMO

OBJECTIVES: Coronavirus disease 2019 has emerged as a major global health threat with a great number of deaths in China. We aimed to assess the association between Acute Physiology and Chronic Health Evaluation II score and hospital mortality in patients with coronavirus disease 2019, and to compare the predictive ability of Acute Physiology and Chronic Health Evaluation II score, with Sequential Organ Failure Assessment score and Confusion, Urea, Respiratory rate, Blood pressure, Age 65 (CURB65) score. DESIGN: Retrospective observational cohort. SETTING: Tongji Hospital in Wuhan, China. SUBJECTS: Confirmed patients with coronavirus disease 2019 hospitalized in the ICU of Tongji hospital from January 10, 2020, to February 10, 2020. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Of 178 potentially eligible patients with symptoms of coronavirus disease 2019, 23 patients (12.92%) were diagnosed as suspected cases, and one patient (0.56%) suffered from cardiac arrest immediately after admission. Ultimately, 154 patients were enrolled in the analysis and 52 patients (33.77%) died. Mean Acute Physiology and Chronic Health Evaluation II score (23.23 ± 6.05) was much higher in deaths compared with the mean Acute Physiology and Chronic Health Evaluation II score of 10.87 ± 4.40 in survivors (p < 0.001). Acute Physiology and Chronic Health Evaluation II score was independently associated with hospital mortality (adjusted hazard ratio, 1.07; 95% CI, 1.01-1.13). In predicting hospital mortality, Acute Physiology and Chronic Health Evaluation II score demonstrated better discriminative ability (area under the curve, 0.966; 95% CI, 0.942-0.990) than Sequential Organ Failure Assessment score (area under the curve, 0.867; 95% CI, 0.808-0.926) and CURB65 score (area under the curve, 0.844; 95% CI, 0.784-0.905). Based on the cut-off value of 17, Acute Physiology and Chronic Health Evaluation II score could predict the death of patients with coronavirus disease 2019 with a sensitivity of 96.15% and a specificity of 86.27%. Kaplan-Meier analysis showed that the survivor probability of patients with coronavirus disease 2019 with Acute Physiology and Chronic Health Evaluation II score less than 17 was notably higher than that of patients with Acute Physiology and Chronic Health Evaluation II score greater than or equal to 17 (p < 0.001). CONCLUSIONS: Acute Physiology and Chronic Health Evaluation II score was an effective clinical tool to predict hospital mortality in patients with coronavirus disease 2019 compared with Sequential Organ Failure Assessment score and CURB65 score. Acute Physiology and Chronic Health Evaluation II score greater than or equal to 17 serves as an early warning indicator of death and may provide guidance to make further clinical decisions.


Assuntos
Causas de Morte , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Mortalidade Hospitalar , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Síndrome Respiratória Aguda Grave/mortalidade , APACHE , Adulto , Idoso , Causalidade , China/epidemiologia , Infecções por Coronavirus/terapia , Feminino , Hospitalização/estatística & dados numéricos , Hospitais Urbanos , Humanos , Unidades de Terapia Intensiva/estatística & dados numéricos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Escores de Disfunção Orgânica , Pandemias , Pneumonia Viral/terapia , Valor Preditivo dos Testes , Modelos de Riscos Proporcionais , Curva ROC , Estudos Retrospectivos , Síndrome Respiratória Aguda Grave/diagnóstico , Síndrome Respiratória Aguda Grave/terapia , Sobreviventes/estatística & dados numéricos
17.
BMC Public Health ; 20(1): 1051, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32616007

RESUMO

BACKGROUND: Violence against children is a pervasive public health issue, with limited data available across multiple contexts. This study explores the rarely studied prevalence and dynamics around disclosure, reporting and help-seeking behaviours of children who ever experienced physical and/or sexual violence. METHODS: Using nationally-representative Violence Against Children Surveys in six countries: Cambodia, Haiti, Kenya, Malawi, Nigeria and Tanzania, we present descriptive statistics for prevalence of four outcomes among children aged 13-17 years: informal disclosure, knowledge of where to seek formal help, formal disclosure/help seeking and receipt of formal help. We ran country-specific multivariate logistic regressions predicting outcomes on factors at the individual, household and community levels. RESULTS: The prevalence of help-seeking behaviours ranged from 23 to 54% for informal disclosure, 16 to 28% for knowledge of where to seek formal help, under 1 to 25% for formal disclosure or help seeking, and 1 to 11% for receipt of formal help. Factors consistently correlated with promoting help-seeking behaviours included household number of adult females and absence of biological father, while those correlated with reduced help-seeking behaviours included being male and living in a female-headed household. Primary reasons for not seeking help varied by country, including self-blame, apathy and not needing or wanting services. CONCLUSIONS: Across countries examined, help-seeking and receipt of formal services is low for children experiencing physical and/or sexual violence, with few consistent factors identified which facilitated help-seeking. Further understanding of help seeking, alongside improved data quality and availability will aid prevention responses, including the ability to assist child survivors in a timely manner.


Assuntos
Saúde da Criança/estatística & dados numéricos , Revelação/estatística & dados numéricos , Sobreviventes/psicologia , Violência/psicologia , Adolescente , Camboja/epidemiologia , Criança , Feminino , Haiti/epidemiologia , Humanos , Quênia/epidemiologia , Modelos Logísticos , Malaui , Masculino , Prevalência , Delitos Sexuais/psicologia , Inquéritos e Questionários , Sobreviventes/estatística & dados numéricos , Tanzânia/epidemiologia , Violência/prevenção & controle
18.
Adv Exp Med Biol ; 1257: 193-207, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32483741

RESUMO

Exercise has the potential to positively affect patients with osteosarcoma by improvement of function, mitigation of disability, and maintenance of independence and quality of life. Exercise may also directly impact cancer treatment efficacy. This chapter examines the feasibility and use of exercise or physical activity as therapy in the treatment of osteosarcoma and its survivors. It additionally presents the benefits of physical activity as treatment and rehabilitation both preoperatively (prehabilitation) and postoperatively. This chapter will also discuss barriers to exercise and physical activity for patients with osteosarcoma and its survivors, emphasizing the need for a comprehensive and cohesive support system to promote its incorporation into patient treatment plans and ensure compliance.


Assuntos
Neoplasias Ósseas , Exercício Físico , Osteossarcoma , Qualidade de Vida , Neoplasias Ósseas/patologia , Neoplasias Ósseas/terapia , Terapia por Exercício/normas , Humanos , Osteossarcoma/patologia , Osteossarcoma/terapia , Sobreviventes/estatística & dados numéricos
19.
Medicine (Baltimore) ; 99(26): e20872, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590792

RESUMO

PURPOSE: Oxidative stress has been shown to reflect on the development of sepsis and disease severity. In the present study, we evaluated the effects of increased levels of oxidative stress and decreased antioxidant coactivity in patients with sepsis, and the importance of oxidative stress on treatment outcomes. METHODS: Biomarkers of oxidative stress (thiobarbituric acid-reactive substances [TBARS]) and antioxidant capacity (glutathione peroxidase [GPx] and glutathione content [thiol]) were prospectively evaluated along with biochemical and clinical data in 100 patients with sepsis on days 1, 4, and 7 after admission. RESULTS: The TBARS level of the non-survivor group was significantly higher than that of the survivor group on day 1 and day 4 and negatively correlated with thiol upon admission. However, thiol was positively correlated with lactate concentration. The TBARS and lactate levels upon admission were independent predictors of fatality. CONCLUSIONS: We conclude that a TBARS cut-off value of 18.30 µM can be used to predict fatality, and an increase in the TBARS concentration by 1 µM will increase the fatality rate by 0.94%. In the panel of biomarkers, the TBARS assay can be considered as a prognostic biomarker for the treatment of patients with sepsis.


Assuntos
Biomarcadores/análise , Estresse Oxidativo/fisiologia , APACHE , Adulto , Idoso , Análise de Variância , Área Sob a Curva , Biomarcadores/sangue , Feminino , Glutationa Peroxidase/análise , Glutationa Peroxidase/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Curva ROC , Compostos de Sulfidrila/análise , Compostos de Sulfidrila/sangue , Sobreviventes/estatística & dados numéricos , Substâncias Reativas com Ácido Tiobarbitúrico/análise
20.
Medicine (Baltimore) ; 99(23): e20514, 2020 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-32501999

RESUMO

Depression is common after patients are discharged from the intensive care unit (ICU) and has a negative impact on quality of life and mortality. There is inconsistent information about ICU admission and the risk of depression. The aim of our study was to investigate the association between the risk of depression and length of ICU stay.ICU survivors between 20 and 65 years old were enrolled in this study using data from Taiwan's nationwide population database. All study subjects were followed for a maximum of 1 year or until they were diagnosed with new-onset depression. The association between the length of ICU stay and the depression risk among ICU survivors was estimated using a Cox regression model. The screened diagnostic records of ICU survivors with depression were also investigated to find the potential disease effect of depression.Compared to patients with ICU stays between 8 and 14 days, the adjusted HR (95% confidence interval) for depression in patients with ICU stays between 1 to 3 days, 4 to 7 days, 15 to 21 days, and ≥22 days were 1.08 (1.03-1.13), 1.01 (0.96-1.05), 1.08 (1.01-1.14), and 1.12 (1.06-1.19), respectively. For patients with depression after discharge from the ICU, the most common primary diagnosis was intracerebral hemorrhage.There is a risk of depression after ICU discharge, and the incidence of depression may be higher among patients between 20 and 49 years old. The risk of depression was U-shaped, with higher risks associated with ICU stays of 1 to 3 days and more than 15 days.


Assuntos
Depressão/complicações , Unidades de Terapia Intensiva/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Adulto , Idoso , Distribuição de Qui-Quadrado , Depressão/psicologia , Feminino , Humanos , Unidades de Terapia Intensiva/organização & administração , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Sobreviventes/psicologia , Sobreviventes/estatística & dados numéricos , Taiwan
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