Fatores de risco e medidas profiláticas nas pneumonias adquiridas na comunidade

Gomes, Lucy

doi:10.1590/s0102-35862001000200008

Cited by 20 publications

(27 citation statements)

References 108 publications

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“…(16,17) In the present study, clinical data related to smoking or respiratory diseases were not found to be associated with the fatal outcomes studied. However, we must underscore that not every smoker develops structural lesions in the respiratory system, since this process also depends on genetic influences of the individual, (18) and that smoking-related structural lesions are not limited to COPD and interstitial lung disease.…”

Section: Discussioncontrasting

confidence: 42%

“…(12)(13)(14)(15) Elderly people present alterations in the defense mechanisms of the respiratory system, with a decrease in mucociliary clearance and in other mechanical barriers, as well as the aging of the immune system and the presence of comorbidities, which facilitate infection with the various microorganisms that cause the disease. (16) There is evidence that being over 65 years of age-presenting or not presenting with the comorbidities that are characteristic of this age bracket (16,17) -is a risk factor for a worse prognosis in NP. In the present study, the mean number of comorbidities/patient in the cases of patients over 60 years of age was 11.3, much higher than the 3.5 observed for patients under 60 years of age, suggesting that the number of comorbidities influences the mortality rate.…”

Section: Discussionmentioning

confidence: 99%

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Determinantes morfológicos de prognóstico em pneumonia nosocomial: um estudo em autópsias

et al. 2010

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Objective: To determine the prevalence of nosocomial pneumonia in autopsies at a public university hospital; to identify the risk factors for nosocomial pneumonia and the potential prognostic factors associated with fatal nosocomial pneumonia and with fatal aspiration pneumonia; and to determine whether anatomopathological findings correlate with nosocomial pneumonia or aspiration pneumonia. Methods: A retrospective study involving 199 autopsied patients, older than 1 year of age, who had been admitted to the São Paulo State University Botucatu School of Medicine Hospital das Clínicas and died of nosocomial pneumonia (underlying or contributing cause), between 1999 and 2006. Demographic, clinical and anatomopathological variables were tested regarding their association with the outcomes (fatal nosocomial pneumonia and fatal aspiration pneumonia). The significant variables were analyzed using multivariate analysis. Results: The mean age was 59 ± 19 years. The prevalence of nosocomial pneumonia in autopsies was 29%, and the disease was the cause of death in 22.6% of the autopsied patients. Fatal nosocomial pneumonia correlated with the following anatomopathological findings: tobacco-associated structural lesions (OR = 3.23; 95% CI: 1.26-2.95; p = 0.02) and bilateral pneumonia (OR = 3.23; 95% CI: 1.26-8.30; p = 0.01). None of the variables were found to be significantly associated with fatal aspiration pneumonia. Conclusions: In our sample, there was a high prevalence of nosocomial pneumonia, which was responsible for almost 25% of all of the deaths. Smoking-related structural lesions and bilateral pneumonia all favored mortality. These findings corroborate the results of various clinical studies on nosocomial pneumonia.Keywords: Autopsy; Risk factors; Prognosis; Pneumonia, aspiration; Pneumonia/mortality. ResumoObjetivo: Determinar a prevalência de pneumonia nosocomial nas autópsias em um hospital público universitário; identificar os fatores de risco relacionados à pneumonia nosocomial e os potenciais fatores prognósticos relacionados à ocorrência de pneumonia nosocomial fatal; e correlacionar os achados anatomopatológicos com a ocorrência de pneumonia nosocomial e/ou pneumonia aspirativa. Métodos: Estudo retrospectivo de 199 pacientes autopsiados, maiores de 1 ano de idade, internados no Hospital das Clínicas da Faculdade de Medicina de Botucatu da Universidade Estadual Paulista entre 1999 e 2006, cuja causa de morte (causa básica ou associada) foi pneumonia nosocomial. Testou-se a associação dos dados demográficos, clínicos e anatomopatológicos com os desfechos pneumonia nosocomial fatal e pneumonia aspirativa fatal. As variáveis significativas entraram na análise multivariada. Resultados: A idade média foi de 59 ± 19 anos. A prevalência de pneumonia nosocomial em autópsias foi 29%, e essa foi a causa mortis de 22,6% dos pacientes autopsiados. A pneumonia nosocomial fatal correlacionou-se com os achados anatomopatológicos de alterações estruturais tabágicas (OR = 3,23; IC95%: 1,26-2,95; p = 0,02) e acom...

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Section: Discussioncontrasting

confidence: 42%

Section: Discussionmentioning

confidence: 99%

Determinantes morfológicos de prognóstico em pneumonia nosocomial: um estudo em autópsias

et al. 2010

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“…They raised the hypothesis that in these smaller communities, the population is more dependent on the public healthcare system and especially the medicines distributed by it, and is thus closer to the primary healthcare services and their recommendations. At any rate, groups of elderly with comorbidities like chronic obstructive pulmonary disease are particularly strong candidates for the vaccine 36 and need specific measures to improve their compliance.…”

Section: Reason N %mentioning

confidence: 99%

Influenza vaccination in non-institutionalized elderly: a population-based study in a medium-sized city in Southern Brazil

Dip

Cabrera

2010

Cad. Saúde Pública

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Vaccination is the most effective measure to prevent the complications of influenza. This population-based study aimed to estimate influenza vaccine coverage in non-institutionalized elderly, analyze the factors involved in lack of influenza vaccine uptake, and identify post-vaccination adverse effects. The study population lived in an urban neighborhood in Southern Brazil, and the sample consisted of 425 elderly. A total of 396 elderly individuals (age 60-95 years) were interviewed. Although 100% of the sample reported knowing about the vaccine, only 5.3% referred to their personal doctor as the source of information. Among elders that had not received the vaccine, 83.2% were explicit about not wanting to take it. The main reasons were fear of adverse effects and disbelief in the vaccine's effectiveness. However, the actual prevalence of adverse effects was low. Age, smoking, and lack of a doctor's appointment in the previous year were independently associated with vaccine non-compliance. The results show that improvements are needed in the immunization campaign, especially targeting elders less than 70 years of age and smokers.

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“…O termo influenza, do latim del fredo (frio), relaciona a doença ao inverno. Já o termo gripe tem sua origem no russo khripu, que quer dizer rouquidão 20 . É considerada uma doença de alta transmissibilidade, principalmente em ambientes fechados, e manifesta-se sob forma de surtos e epidemias, sendo sua transmissão através do contato com pessoas gripadas, por meio do ar ou da saliva.…”

Section: Os áCidos Siálicos Como Fonte De Inspiração Para O Desenho Dunclassified

“…Recentemente o composto BCX-1812 (RWJ270201, 21), que foi desenhado a partir do derivado da furanose (20), mostrou uma excelente atividade inibitória da sialidase do vírus influenza não somente in vitro, mas também in vivo. Este composto encontra-se atualmente em fase 3 na triagem clínica.…”

Section: Inibidores Com Anéis De 5-membrosunclassified

Ácidos siálicos: da compreensão do seu envolvimento em processos biológicos ao desenvolvimento de fármacos contra o agente etiológico da gripe

Fátima¹,

Baptistella²,

Pilli³

et al. 2005

Quím. Nova

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Recebido em 4/2/04; aceito em 13/7/04; publicado na web em 23/11/04 SIALIC ACIDS -FROM THE COMPREHENSION OF THEIR INVOLVEMENT IN BIOLOGICAL PROCESSES TO ANTIINFLUENZA DRUG DESIGN. Sialic acids are nine-carbon carbohydrates that occur widely in nature and occupy the terminal portions of some glycoproteins and glycolipids of cell membranes. These carbohydrates are closely involved in cell-cell interactions and in processes such as microbial infection, inflammation, etc. Studies on the participation of sialic acids in biological processes have provided comprehension about their role in the infection by the influenza virus, the causal agent of flu. In this article, we present an overview of the importance of sialic acids in the influenza virus infection and how the knowledge of their involvement in this process has allowed the development of selective and efficient drugs against the virus.Keywords: sialic acid; flu and antiinfluenza drugs. INTRODUÇÃONão há vida sem célula. E a exemplo da própria vida, que tanta diversidade apresenta, variam as formas e funções das células. As células são as unidades estruturais e funcionais de todos os organismos e é possível reconhecer, em sua hierarquia estrutural, alguns níveis de complexidade, como aqueles presentes, por exemplo, em uma célula vegetal: o nível 3 onde se incluem complexos supramoleculares (cromossomo, membrana plasmática, parede celular, etc); o nível 2 representado por macromoléculas (DNA, proteínas, celulose, etc) e o nível 1 compreendendo as unidades monoméricas, como nucleotídeos, aminoácidos, carboidratos, etc 1-3 (Figura 1).A membrana plasmática, presente em células de todas as espécies, define a periferia da célula, separando o seu conteúdo da circunvizinhança. Ela serve como uma barreira de permeabilidade, que permite à célula manter uma composição citoplasmática e é composta de grande número de moléculas de lipídios e proteínas que se mantêm juntas principalmente por interações hidrofóbicas, formando uma bicamada lipídica fina, resistente e flexível, em volta da célula 1-3 . Algumas proteínas presentes na membrana celular permitem a passagem de certos íons e moléculas (proteínas transportadoras). Outras proteí-nas exercem o papel de receptores, transmitindo o sinal do exterior para o interior da célula. Há ainda proteínas que funcionam como enzimas, participando de reações que ocorrem em membranas.

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Fatores de risco e medidas profiláticas nas pneumonias adquiridas na comunidade

Abstract: 97 Fatores de risco e medidas profiláticas nas pneumonias adquiridas na comunidade

Cited by 20 publications

References 108 publications

Determinantes morfológicos de prognóstico em pneumonia nosocomial: um estudo em autópsias

Determinantes morfológicos de prognóstico em pneumonia nosocomial: um estudo em autópsias

Influenza vaccination in non-institutionalized elderly: a population-based study in a medium-sized city in Southern Brazil

Ácidos siálicos: da compreensão do seu envolvimento em processos biológicos ao desenvolvimento de fármacos contra o agente etiológico da gripe

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