Background Non-invasive oxygenation strategies have a prominent role in the treatment of acute hypoxemic respiratory failure during the coronavirus disease 2019 (COVID-19). While the efficacy of these therapies has been studied in hospitalized patients with COVID-19, the clinical outcomes associated with oxygen masks, high-flow oxygen therapy by nasal cannula and non-invasive mechanical ventilation in critically ill intensive care unit (ICU) patients remain unclear. Methods In this retrospective study, we used the best of nine covariate balancing algorithms on all baseline covariates in critically ill COVID-19 patients supported with > 10 L of supplemental oxygen at one of the 26 participating ICUs in Catalonia, Spain, between March 14 and April 15, 2020. Results Of the 1093 non-invasively oxygenated patients at ICU admission treated with one of the three stand-alone non-invasive oxygenation strategies, 897 (82%) required endotracheal intubation and 310 (28%) died during the ICU stay. High-flow oxygen therapy by nasal cannula (n = 439) and non-invasive mechanical ventilation (n = 101) were associated with a lower rate of endotracheal intubation (70% and 88%, respectively) than oxygen masks (n = 553 and 91% intubated), p < 0.001. Compared to oxygen masks, high-flow oxygen therapy by nasal cannula was associated with lower ICU mortality (hazard ratio 0.75 [95% CI 0.58–0.98), and the hazard ratio for ICU mortality was 1.21 [95% CI 0.80–1.83] for non-invasive mechanical ventilation. Conclusion In critically ill COVID-19 ICU patients and, in the absence of conclusive data, high-flow oxygen therapy by nasal cannula may be the approach of choice as the primary non-invasive oxygenation support strategy.
Objectives: To assess the prevalence of asthma symptoms among schoolchildren aged six to seven years in the municipality of Picos-PI; and to identify risk factors associated with the disease. Methods: A cross-sectional study with children aged six and seven from Picos, in November 2010 and May 2011. To collect data, we used an adapted form of the International Study of Asthma and Allergies in Childhood. Data were analyzed using descriptive and analytical statistics. Results: Among the 234 children in the study sample, 56% were female. The prevalence of the medical diagnosis of asthma was 7.7%. The following risk factors presented a statistically significant relationship with the occurrence of asthma (p <0.05): wheezing after physical exercise, dry cough at night without having a cold, bronchitis, and having parents with asthma. Conclusion: We observed an underdiagnosis of asthma; there is a necessity for further work to be conducted with a larger sample, to examine more broadly the situation of asthma in children in the municipality of Picos -PI. Keywords: Asthma; Risk factors; Symptoms; Child; Pediatric nursing RESUMO Objetivos: Analisar a prevalência de sintomas de asma entre escolares de seis a sete anos do município de Picos-PI; e identificar fatores de risco associados à doença. Métodos: Estudo transversal realizado com crianças de 6 e 7 anos de Picos em novembro de 2010 a maio de 2011. Para coletar os dados, foi utilizado um formulário adaptado do Internacional Study of Asthma and Allergies in Childhood. Os dados foram analisados com base na estatística descritiva e analítica. Resultados: Dentre as 234 crianças da amostra estudada, 56% eram do gênero feminino. A prevalência de diagnóstico médico de asma foi de 7,7%. Os seguintes fatores de risco apresentaram relação estatisticamente significante com a ocorrência de asma (p < 0,05): sibilos após a realização de exercício físico, tosse seca à noite sem estar gripado, bronquite, e ter pais asmáticos. Conclusão: Observou-se o subdiagnóstico da asma e há necessidade de que novos trabalhos sejam realizados com uma amostra maior, para analisar de modo mais amplo a situação da asma em crianças no município de Picos -PI. Descritores: Asma; Fatores de risco; Sintomas; Criança; Enfermagem pediátrica RESUMEN Objetivos: Analizar la prevalencia de síntomas de asma entre escolares de seis a siete años del municipio de Picos-PI; e identificar factores de riesgo asociados a la enfermedad. Métodos: Estudio transversal realizado con niños de 6 y 7 años de Picos en noviembre de 2010 a mayo de 2011. Para recolectar los datos, se utilizo un formulario adaptado del Internacional Study of Asthma and Allergies in Childhood. Los datos fueron analizados con base en la estadística descriptiva y analítica. Resultados: De los 234 niños de la muestra estudiada, el 56% era del género femenino. La prevalencia del diagnóstico médico de asma fue de 7,7%. Los siguientes factores de riesgo presentaron relación estadísticamente significativa con la ocurrencia de asma (p < 0,05): sibila...
Purpose In the critically ill, hospital-acquired bloodstream infections (HA-BSI) are associated with significant mortality. Granular data are required for optimizing management, and developing guidelines and clinical trials. Methods We carried out a prospective international cohort study of adult patients (≥ 18 years of age) with HA-BSI treated in intensive care units (ICUs) between June 2019 and February 2021. Results 2600 patients from 333 ICUs in 52 countries were included. 78% HA-BSI were ICU-acquired. Median Sequential Organ Failure Assessment (SOFA) score was 8 [IQR 5; 11] at HA-BSI diagnosis. Most frequent sources of infection included pneumonia (26.7%) and intravascular catheters (26.4%). Most frequent pathogens were Gram-negative bacteria (59.0%), predominantly Klebsiella spp. (27.9%), Acinetobacter spp . (20.3%), Escherichia coli (15.8%), and Pseudomonas spp . (14.3%). Carbapenem resistance was present in 37.8%, 84.6%, 7.4%, and 33.2%, respectively. Difficult-to-treat resistance (DTR) was present in 23.5% and pan-drug resistance in 1.5%. Antimicrobial therapy was deemed adequate within 24 h for 51.5%. Antimicrobial resistance was associated with longer delays to adequate antimicrobial therapy. Source control was needed in 52.5% but not achieved in 18.2%. Mortality was 37.1%, and only 16.1% had been discharged alive from hospital by day-28. Conclusions HA-BSI was frequently caused by Gram-negative, carbapenem-resistant and DTR pathogens. Antimicrobial resistance led to delays in adequate antimicrobial therapy. Mortality was high, and at day-28 only a minority of the patients were discharged alive from the hospital. Prevention of antimicrobial resistance and focusing on adequate antimicrobial therapy and source control are important to optimize patient management and outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-022-06944-2.
Objetivo: analisar a mortalidade neonatal no município de Picos- PI de acordo com as informações contidas na Declaração de Óbito e Declaração de Nascido Vivo. Métodos: realizou-se pesquisa documental, retrospectiva e quantitativa. Utilizou-se a técnica de linkage, possibilitando o cruzamento entre os bancos de dados do Sistema de Informação sobre Nascidos Vivos e do Sistema de Informação sobre Mortalizade. A população foi composta por todos os óbitos neonatais totalizando 72 óbitos ocorridos no período de 2011 a 2015. Resultados: houve predomínio de óbitos neonatais precoces e tardios em recém-nascidos cujas mães tiveram gestação única (83,9%; 88,9%, respectivamente) e do sexo masculino (54,0%; 77,8%, respectivamente). O óbito neonatal esteve associado ao tipo de parto (redução de 60% nos partos cesarianos) e ao estabelecimento de saúde. As causas básicas mais frequentes do óbito neonatal precoce e tardio foram as afecções originadas no período perinatal e as septicemias bacterianas não especifica do recém-nascido, respectivamente. Conclusões: espera-se que esses resultados possam subsidiar mudanças nas práticas assistenciais, planejamento e organização da rede de atenção materno-infantil no município.
Article linked to research: Risk factors for cardiovascular diseases in children and adolescentes from Picos -PI. Conflicts of interest: none to declare. Funding: Institutional Program for ScientificInitiation Grants/UFPI/CNPq. Original article Risk factors for cardiovascular disease in adolescentsObjective. Identify risk factors for cardiovascular disease in adolescents. Methodology. Descriptive cross-sectional study, conducted from May to September 2012, in the public schools of the city of Picos (Piaui State, Brazil). The sample consisted of 320 adolescents 10-19 years. Results. As to gender, 60% were female. With regard to blood pressure values, 15.3% of participants had altered blood pressure values (6.9% with hypertension) and, in relation to nutritional status, 15.6% were overweight and 5.3% obese. None of the variables showed statistically significant differences according to sex. Correlation were found between the variables: family history of hypertension with arm circumference and triceps skinfold; maternal education with triceps skinfold thickness and diastolic blood pressure; uptime with body mass index, arm circumference, waist-hip ratio and heart rate; birth weight with body mass index and arm circumference. Conclusion. A significant proportion of adolescent respondents had risk factors for cardiovascular disease. Nursing should lead the adoption of interventions that promote the improvement of healthy lifestyle in adolescence, thus avoiding not only cardiovascular disease, but also other chronic diseases that can develop.Key words: Risk factors; cardiovascular diseases; nursing; adolescent. Factores de riesgo para la enfermedad cardiovascular en adolescentesObjetivo. Identificar los factores de riesgo de enfermedad cardiovascular en adolescentes. Metodología. Estudio descriptivo de tipo transversal, llevado a cabo entre mayo y septiembre de 2012, en las escuelas públicas del municipio de Picos (Estado de Piauí, Brasil). La muestra estuvo constituida por 320 adolescentes de 10 a 19 años. Resultados. El 60% de los participantes era de sexo femenino. El 15.3% de los participantes presentó valores de presión arterial alterados (6.9% con hipertensión arterial). Con relación al estado nutricional, el 15.6 tuvo sobrepeso y el 5.3% 316 • Invest Educ Enferm. 2015;33 (2) obesidad. En ninguna de las dos variables se observaron diferencias estadísticamente significativas por sexo. Existe correlación entre las variables: historia familiar de hipertensión con la circunferencia del brazo y pliegue tricipital; educación de la madre con el espesor del pliegue cutáneo tricipital y con la presión arterial diastólica; el tiempo de actividad con el índice de masa corporal, la circunferencia del brazo tasa, la relación y el corazón cintura-cadera; el peso al nacer con el índice de masa corporal y la circunferencia del brazo. Conclusión. Una proporción importante de los adolescentes encuestados tienen factores de riesgo para enfermedad cardiovascular. Enfermería debe liderar la adopción de intervenciones que propendan ...
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