The objective of this meta-analysis was to evaluate the factors associated with the mortality of elderly Italians diagnosed with coronavirus who resided in institutions or who were hospitalized because of the disease. Methods: A systematic review following the recommendations of The Joanna Briggs Institute (JBI) was carried out, utilizing the PEO strategy, i.e., Population, Exposure and Outcome. In this case, the population was the elderly aged over 65 years old, the exposure referred to the SARS-CoV-2 pandemic and the outcome was mortality. The National Center for Biotechnology Information (NCBI/PubMed), Latin American and Caribbean Literature in Health Sciences (LILACS), Excerpta Medica Database (EMBASE) and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases were used until 31 July 2020. Results: Five Italian studies were included in this meta-analysis, with the number of elderly people included varying between 18 and 1591 patients. The main morbidities presented by the elderly in the studies were dementia, diabetes, chronic kidney disease and hypertension. Conclusions: The factors associated with the mortality of elderly Italian people diagnosed with SARS-CoV-2 who lived in institutions or who were hospitalized because of the disease were evaluated. It was found that dementia, diabetes, chronic kidney disease and hypertension were the main diagnosed diseases for mortality in elderly people with COVID-19.
r e v b r a s r e u m a t o l. 2 0 1 7;5 7(6):596-604 w w w. r e u m a t o l o g i a. c o m. b r Antiemetics Chemotherapy Cystitis a b s t r a c t Cyclophosphamide is an alkylating agent widely used for the treatment of malignant neo-plasia and which can be used in the treatment of multiple rheumatic diseases. Medication administration errors may lead to its reduced efficacy or increased drug toxicity. Many errors occur in the administration of injectable drugs. The present study aimed at structuring a routine for cyclophosphamide use, as well as creating a document with pharmacotherapeu-tic guidelines for the patient. The routine is schematized in three phases: pre-chemotherapy, administration of cyclophosphamide, and post-chemotherapy, taking into account the drugs to be administered before and after cyclophosphamide in order to prevent adverse effects, including nausea and hemorrhagic cystitis. Adverse reactions can alter laboratory tests; thus, this routine included clinical management for changes in white blood cells, platelets, neutrophils, and sodium, including cyclophosphamide dose adjustment in the case of kidney disease. Cyclophosphamide is responsible for other rare-but serious-side effects, for instance, hepatotoxicity, severe hyponatremia and heart failure. Other adverse reactions include hair loss, amenorrhea and menopause. In this routine, we also entered guidelines to post-chemotherapy patients. The compatibility of injectable drugs with the vehicle used has been described, as well as stability and infusion times. The routine aimed at the rational use of cyclophosphamide, with prevention of adverse events and relapse episodes, factors that may burden the health care system. (K.A. Teles), pmedeirossouza@uol.com.br (P. Medeiros-Souza). http://dx.doi.org/10.1016/j.rbre.2016.09.008 2255-5021/© 2016 Elsevier Editora Ltda. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/ licenses/by-nc-nd/4.0/). r e v b r a s r e u m a t o l. 2 0 1 7;5 7(6):596-604 597 Rotina de administração de ciclofosfamida em doenças autoimunes reumáticas: uma revisão Palavras-chave: Ciclofosfamida Antieméticos Quimioterapia Cistite r e s u m o A ciclofosfamida é um agente alquilante vastamente usado para o tratamento de neoplasias malignas e pode ser usado no tratamento de diversas doenças reumatológicas. O erro de administração de medicamentos pode levar à diminuição da eficácia ou ao aumento da toxicidade medicamentosa. Diversos erros ocorrem na administração de medicamentos injetáveis. O trabalho objetivou a estruturação de uma rotina do uso de ciclofosfamida, bem como a criação de um documento de orientaç ões farmacoterapêuticas para o paciente. A rotina foi esquematizada em três fases, a pré-quimioterapia, a administração da ciclofos-famida e a pós-quimioterapia, que levaram em consideração os medicamentos que devem ser administrados antes e depois da ciclofosfamida para prevenção aos efeitos adversos, incluindo náusea e cistite hemorrágica. As reaç ões adversas podem alterar os exames...
RESUMOO surto do novo coronavírus na China decretado como pandemia pela Organização Mundial da Saúde, tem sido um grande problema de saúde pública. A busca de tratamentos alternativos para tratar a doença são vários, dentre eles o uso do medicamento Hidroxicloroquina (HCQ). A HCQ é um fármaco utilizado no tratamento de artrites, doenças autoimune, atualmente vem sendo questionada quanto a atuação no COVID19, no momento existe apenas testes in vitro para esta atuação. Dessa forma a prática da automedicação por essa substância tem crescido. Este trabalho tem como objetivo descrever as reações e interações medicamentosas da HCQ, descrevendo os riscos inerentes a automedicação durante a pandemia, bem como discorrer sobre a atuação da mídia e das autoridades governamentais. A metodologia adotada baseia-se em uma revisão bibliográfica no qual utilizou-se levantamento de artigos dos últimos dez anos dispondo das bases de dados LILACS, Scielo, BVS, FioCruz. Os resultados mostraram que a HCQ apresenta reações adversas graves podendo inclusive levar a óbito, além de não apresentar até este momento eficácia comprovada na cura da COVID-19. Devido a informações veiculadas na mídia e defendida por autoridades a HCQ apresentou um aumento nas vendas durante a pandemia. Isso fez com que a Agência Nacional de Vigilância Sanitária tornasse a HCQ um medicamento controlado através de uma RDC. Inferese que a busca por um tratamento ou vacina que combata o coronavírus é crucial neste momento para sanar a pandemia.
The objective of this meta-analysis was to evaluate the factors associated with mortality of elderly Italians diagnosed with the new coronavirus who resided in institutions or who were hospitalized as a result of the disease. Methods: A systematic review following the recommenda-tions of The Joanna Briggs Institute (JBI), where the PEO strategy was utilized - Population, Exposure and Outcome. P, being the elderly over 65 years old. E, the SARS-CoV_2 pandemic. O, mortality. The NCBI / PubMed, LILACS, EMBASE and CINAHL databases were used until July 31, 2020.; Results: Five Italian studies were included in the meta-analysis, with the number of elderly people varying between 18 and 1591 patients. The main morbidities presented by the elderly in the studies were: dementia, diabetes, chronic kidney disease and hypertension. Conclusions: The factors as-sociated with the mortality of elderly Italian people diagnosed with SARS-CoV-2 who lived in in-stitutions or who were hospitalized because of the disease were evaluated. It was found that de-mentia, diabetes, chronic kidney disease and hypertension are the main the main diagnosed dis-eases for mortality in elderly people with Covid-19.
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