Alguns dos recursos utilizados em fisioterapia respiratória não são baseados em evidências científicas comprovadas. A má utilização desses recursos pode ser nociva do ponto de vista de efeitos adversos, ou levar a um custo-benefício não favorável. Os autores fizeram uma revisão sistemática da literatura, através das bases de dados Oldmedline, Medline, Cinahl, Lilacs, e nos registros de ensaios clínicos da Biblioteca Cochrane e do National Institutes of Health, dos EUA, visando a encontrar ensaios sobre a eficácia da fisioterapia respiratória no empiema pleural em crianças, adolescentes ou adultos. Nenhum ensaio sobre o assunto foi encontrado. Os autores concluem que faltam evidências sobre a eficácia da fisioterapia no empiema pleural. Ensaios clínicos são necessários para responder a esta questão.
In a case series of 152 children aged from 2 to 132 months will pleural emphema from a paediatric tertiary hospital in Luanda, Angola between September 2004 and March 2005, the authors found a high prevalence of anaemia and malnutrition. The most prevalent bacteria in pleural fluid were: D pneumoniae, Haemophyllus and S aureus. The median for hospital stay was 25 days. The lethality was 7.8% and was not statistically associated with malnutrition, although this variable was associated, in multivariate analysis, with prolonged hospitalization time.
Introduction:Group B Streptococcus (GBS) is a gram-negative diplococcus found in women as part of the vaginal flora. It is the main risk factor for early neonatal infection, causing up to 25% of deaths in affected newborns. Objective: To determine the prevalence of group B streptococcus colonization in pregnant women who attended the Obstetrics, Emergency Department and Delivery Room at the Lucrécia Paim and Augusto N'gangula Maternity Hospital in Luanda, from January to March 2019. Methodology: A prospective cross-sectional study was carried out on 382 pregnant women, of which 183 were excluded. Vaginal and anorectal specimens were collected using a sterile swab. The samples obtained were stored in Stuart transport medium, inoculated in Stuart selective medium with subsequent subculture on blood agar plates. Socioeconomic and clinical-obstetric variables were also analyzed. Data were analyzed using the SPSS program. The non-probabilistic sampling technique for consecutive convenience was used. Results: The prevalence of maternal GBS colonization was 38.5%. There was a higher prevalence of GBS in the age group of 21 -30 years and in multiparous women, with 46% and 42.8% of the cases, respectively. Gestational age greater than 35 weeks was the risk factor with the greatest influence on GBS colonization and in the comparative analysis it showed a statistically significant association (p=0.02).Conclusion: The prevalence of group B streptococcus in our country is high. Screening is essential for all pregnant women for diagnosis, treatment, reduction of vertical transmission and reduction of cases of neonatal infection.
Introduction: The pneumonia necrotizing It is one illness defined as consolidation of a pulmonary segment with necrosis in its periphery with multiple cavities, walls thin visible for the Tomography Axial computerized. Objective: To describe the clinical, laboratory and imaging profile of children admitted to the David Bernardino Pediatric Hospital (Angola) with necrotizing pneumonia from February to October 2018. Methodology: Study prospective type series in cases accomplished in 18 children with ages understood in between two months and 14 years old in age. Were analyzed at variables age, sex, vaccination status, nutritional status, socio-economic level of country, disease duration before diagnosis, previous antibiotic therapy and results in exams in diagnosis, treatment, complications and state the exit. Results: The mean age was 39 months. Fever was present in 100% From cases, The difficulty respiratory in 94.4%, malnutrition moderate in 39% and anemia in 50% of cases. The erythrocyte sedimentation rate was in mean of 97 mm Hg in the 1st hour, the number of leukocytes of 36,100/mm3 and the length of stay of 39 days. Streptococcus pneumoniae was isolated in pleural fluid in 16.6% of cases, Staphylococcus aureus and Proteus mirabilis in 11.1% of cases. The most frequent complications were empyema with fistula (77%), empyema without fistula (15.5%) and Pyopneumothorax (7.5%). Conclusion: The diagnosis of necrotizing pneumonia must be considered in children who maintain a fever despite adequate treatment of pneumonia.
Introduction: Lung abscesses are cavities in the lung parenchyma with necrotic lung tissue and fluid inside. Objective: To describe the characteristics of children admitted to the David Bernardino Pediatric Hospital with lung abscess from June 2018 to February 2019. Methodology: Prospective descriptive study carried out in 18 children and adolescents aged 2 months to 14 years, admitted to the David Bernardino Pediatric Hospital with pulmonary abscess confirmed by chest X-ray. Through a form, information on clinical processes and companions, the variables age, sex, nutritional status, vaccination, clinical manifestations, previous antibiotic therapy, underlying diseases, radiological findings, type of abscess, type and duration of treatment and complications were evaluated and analyzed. Results: The most affected age group was 5-9 years old, with 50% of cases. The most frequent symptom was fever (100%), followed by cough and dyspnea with 94.4 and 38.9% of cases, respectively. Malnutrition was present in 16.7% of the cases. 66.7% of the children presented a vaccination card, of which 44.4% had a complete vaccination schedule for their age. In 88.9% of the cases the abscesses were single, 66.7% secondary. and 94.4% were located in the right lung. Clindamycin and postural drainage was the treatment instituted in 100% of the cases. Pleural effusion and empyema were complications in 5.6 % of cases. The mean hospital stay was 19.7 days. 94.4% of children were discharged. Conclusion: Lung abscess is a rare complication of pneumonia in children and is often secondary to foreign body aspiration. Despite being severe, the prognosis is good.
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