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Parmezan S.N.,Farmaceutica Bioquimica | Pasternak J.,Medicina | Dezene A.H.P.,Federal University of Sao Paulo | Dalla Valle Martino M.,Setor Of Microbiologia Do Laboratorio | De Souza A.V.,University of Sao Paulo
Jornal Brasileiro de Patologia e Medicina Laboratorial | Year: 2011

Introduction: Human metapneumovirus (HMPV) is responsible for respiratory infections in children and immunocompromised adults and elders. It is commonly diagnosed by immunofluorescence or molecular biology. Objective: To detect HMPV in clinical samples by polymerase chain reaction (PCR) and direct imunofluorescence (DIF) methods. Results: Two percent of 202 samples were positive for DIF and 4% of them for reverse transcriptase PCR (RT-PCR), respectively. Considering RT-PCR as gold standard, DIF sensitivity and specificity were 50% and 100%, respectively. Conclusion: Not only does the study show that RT-PCR is the best method for HMPV detection in clinical respiratory samples but it also substantiates the importance of test standardization in laboratory routine. Source


Objective: Characterize occupational accidents with exposure to biological material which happened in towns in the southern region of Brazil and which were reported to SINAM (National Notification System) in the years of 2010 until 2012. Method: The data were collected directly from the data bank of SINAM in July 2013. The data analyzed were: gender, age, city were the report was made, occupation, employment contract, type of organic material, known or unknown source, agent, vaccination status of the injured person, actions taken immediately after the accident and emission of CAT ('statement of work accident') Statistical analyzes were performed by employing the test-Williams G, and chi-square. Results: During the period of time which was analyzed, there were 58 accidents involving 52 professionals. Only four out of the 16 cities involved in the study reported the accidents. Most of the accidents involved nurses who had finished high school but still hadńt finished their nursing degree. The most frequent kind of accident was percutaneous caused by lumen needles with presence of blood. Conclusion: Therés the necessity of continuous training for nurses with emphasis in biosecurity norms as this was the group of professionals with the most accidents. Source


Fontes M.J.F.,Federal University of Minas Gerais | Affonso A.G.A.,Pneumologia Pediatrica | Calazans G.M.C.,Pneumologia Pediatrica | De Andrade C.R.,Federal University of Minas Gerais | And 3 more authors.
Jornal de Pediatria | Year: 2011

Objectives: To assess the frequency of hospitalizations and emergency department visits of children and adolescents before and after the enrolment in an asthma program. Methods: Medical records of 608 asthmatics younger than 15 years were assessed retrospectively. The frequency of hospitalizations and emergency department visits caused by exacerbations were evaluated before and after enrolment in an asthma program. Patients were treated with medications and a wide prophylactic management program based on the Global Initiative for Asthma (GINA). The before asthma program (BAP) period included 12 months before enrollment, whereas the after asthma program (AAP) period ranged from 12 to 56 months after enrollment. Results: In the BAP period, there were 895 hospitalizations and 5,375 emergency department visits, whereas in the AAP period, there were 180 and 713, respectively. This decrease was significant in all statistical analyses (p = 0.000). Conclusions: Compliance with the GINA recommendations led to a significant decrease in the frequency of hospitalizations and emergency department visits in children and adolescents with asthma. Copyright © 2011 by Sociedade Brasileira de Pediatria. Source


Quintana J.M.,Barrio Labeaga s n | Esteban C.,Direccion Economica | Garcia-Gutierrez S.,Barrio Labeaga s n | Aguirre U.,Barrio Labeaga s n | And 34 more authors.
Respiration | Year: 2014

Background: Limited information is available regarding the factors related to short-term hospital admission following an exacerbation of chronic obstructive pulmonary disease (eCOPD).Objectives: The aim of this study was to identify variables related to short-term admission in patients with an eCOPD.Methods: This was a prospective cohort study of patients with an eCOPD who attended an emergency department (ED) at 1 of 16 hospitals. Information on possible predictor variables was recorded during the ED stay, 24 h after admission to the hospital or after ED discharge home, and at hospital discharge or 1 week later if discharged home from the ED. An admission after an eCOPD within 2 months was the outcome of interest. Multivariate models were employed for patients admitted to the hospital or discharged home from the ED.Results: For patients discharged home from the ED, eCOPD-related hospital admissions in the previous year [odds ratio (OR) 1.98 and 2.33], pCO2 at ED admission (ORs2.02 and 2.90), the number of ED visits within 1 week of the index ED visit (OR 5.14) and dyspnea level 1 week after the index ED visit (ORs 2.66 and 1.40) were predictors of shortterm admission [area under the curve (AUC) 0.82]. For patients admitted to the hospital during the index ED visit, baseline FEV 1 % (ORs 1.32 and 1.88), eCOPD-related hospital admissions in the previous year (ORs 1.28 and 2.51), severe baseline dyspnea (OR 2.57) and dyspnea level 1 week after the index ED visit (ORs 2.15 and 1.74) were predictors of short-term readmission (AUC 0.73).Conclusions: Just a few easily recorded parameters may allow clinicians to identify patients at a higher risk of short-term readmission and establish preventive strategies. © 2014 S. Karger AG, Basel. Source


Esteban C.,Hospital Galdakao UsansoloBizkaia | Quintana J.M.,Red de Investigacion en Servicios Sanitarios y Enfermedades Cronicas REDISSEC | Quintana J.M.,Research Unit | Garcia-Gutierrez S.,Red de Investigacion en Servicios Sanitarios y Enfermedades Cronicas REDISSEC | And 39 more authors.
International Journal of COPD | Year: 2016

Background: Data are scarce on patient physical activity (PA) level during exacerbations of chronic obstructive pulmonary disease (eCOPD). The objective of the study was to evaluate the level and determinants of change in PA during an eCOPD. Materials and methods: We conducted a prospective cohort study with recruitment from emergency departments (EDs) of 16 participating hospitals from June 2008 to September 2010. Data were recorded on socioeconomic characteristics, dyspnea, forced expiratory volume in 1 second (FEV1%), comorbidities, health-related quality of life, factors related to exacerbation, and PA in a stable clinical condition and during the eCOPD episode. Results: We evaluated 2,487 patients. Common factors related to the change in PA during hospital admission or 7 days after discharge to home from the ED were lower PA at baseline and during the first 24 hours after the index evaluation. Age, quality of life, living alone, length of hospital stay, and use of anticholinergic or systemic corticosteroids in treating the exacerbation were associated with the change in PA among hospitalized patients. Predictors of change among patients not admitted to hospital were baseline FEV1% and dyspnea at rest on ED arrival. Conclusion: Among the patients evaluated in an ED for an eCOPD, the level and change in PA was markedly variable. Factors associated with exacerbation (PA 24 hours after admission, medication during admission, and length of hospital stay) and variables reflecting patients’ stable clinical condition (low level of PA, age, quality of life, FEV1%) are predictors of the change in PA during a moderate-to-severe eCOPD. © 2016 Esteban et al. Source

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