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1.
Rev. invest. clín ; Rev. invest. clín;75(6): 318-326, Nov.-Dec. 2023. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1560117

RESUMO

ABSTRACT Home hemodialysis (HD) and automated peritoneal dialysis (APD) have advantages over HD in hospitals or HD centers. Home therapies are generally less expensive and give patients greater mobility and freedom for work, school, family, and recreational activities. Technological advances have made it possible to complement APD with devices for remote monitoring (RM) of the patient. With them, objective information generated in the APD device is collected and sent to repositories "in the cloud" for analysis or at the time decided by the health team. With APD+RM, it is possible to monitor therapeutic compliance, effective dialysis time, ultrafiltration volumes, inflow and outflow patterns of dialysis fluid, and patient actions to respond to alarms that indicate deviations from the parameters set by the nephrologist. The results of APD+RM show good acceptance by the patient, nephrologists, and nurses, treatment adherence has improved, hospitalizations and technique failure have decreased, and some aspects of quality of life have improved. However, there is a lack of controlled clinical trials that reliably demonstrate lower mortality and comorbidity due to specific causes.

2.
Rev Invest Clin ; 75(6): 318-326, 2023 12 18.
Artigo em Inglês | MEDLINE | ID: mdl-37913763

RESUMO

Home hemodialysis (HD) and automated peritoneal dialysis (APD) have advantages over HD in hospitals or HD centers. Home therapies are generally less expensive and give patients greater mobility and freedom for work, school, family, and recreational activities. Technological advances have made it possible to complement APD with devices for remote monitoring (RM) of the patient. With them, objective information generated in the APD device is collected and sent to repositories "in the cloud" for analysis or at the time decided by the health team. With APD+RM, it is possible to monitor therapeutic compliance, effective dialysis time, ultrafiltration volumes, inflow and outflow patterns of dialysis fluid, and patient actions to respond to alarms that indicate deviations from the parameters set by the nephrologist. The results of APD+RM show good acceptance by the patient, nephrologists, and nurses, treatment adherence has improved, hospitalizations and technique failure have decreased, and some aspects of quality of life have improved. However, there is a lack of controlled clinical trials that reliably demonstrate lower mortality and comorbidity due to specific causes.


Assuntos
Falência Renal Crônica , Diálise Peritoneal , Humanos , Qualidade de Vida , Diálise Peritoneal/métodos , Diálise Renal , Hospitalização , Tecnologia , Falência Renal Crônica/terapia
3.
Rev. argent. mastología ; 42(153): 28-46, mar. 2023. ilus
Artigo em Espanhol | LILACS, BINACIS | ID: biblio-1567884

RESUMO

Objetivo: El objetivo de la presente investigación es evaluar nuestra experiencia inicial en la implementación de la mamografía con inyección de contraste (MCIC) y realizar una revisión de la literatura actual respecto de sus indicaciones. Los estudios se realizaron utilizando mamógrafo con capacidad de realizar MCIC, inyección de contraste iodado endovenoso y posterior toma de las imágenes mamográficas habituales (baja y alta energía). Se incluyeron 20 pacientes, invitadas a participar entre quienes concurrieron a realizar biopsias por punción histológicas. Una paciente realizó un segundo estudio al finalizar la terapia neoadyuvante. Dos de 20 (10%) pacientes tuvieron solo lesiones benignas que no realzaron y 18/20 (90%) lesiones malignas que realzaron. Se biopsiaron 27 lesiones, 4 (15%) fueron benignas y 23 (85%) malignas. La extensión del realce coincidió con la lesión visible en imágenes de baja energía en 9/18 (50%) pacientes, en 1/18 (5%) parte del realce mayor a la imagen de baja energía correspondió a una lesión benigna (falso positivo) y en 8/18 (45%) el realce mayor a la imagen de baja energía se corroboró histológicamente. En 4 (22%) pacientes se modificó la estrategia quirúrgica. En el examen post neoadyuvancia se observó respuesta imagenológica completa, reportándose en la cirugía, lesión residual invasora de 2mm. No se presentaron reacciones alérgicas ni otras complicaciones. Se realizó revisión de indicaciones en la literatura. Conclusiones: Nuestra experiencia inicial y curva de aprendizaje muestran que la MCIC es segura y con buenos resultados(AU)


Objetive The purpose of the investigation is to evaluate our initial experience with the implementation of contrast enhanced mammography (CEM) and a review of the current publications regarding its indications. The study was performed with a mammographic unit with CEM capability and iodine-based contrast medium injection. Low and high energy images (recombined image) were obtained in standard incidences. Twenty patients were invited to participate among those that came to undergo breast core biopsies. One patient had two studies, the second after neoadjuvant therapy. Two of 20 (10%) patients had only benign lesions that did not enhanced and 18/20 (90%) had malignant lesions that enhanced. Twenty-seven lesions were biopsied, 4 (15%) were benign and 23 (85%) were malignant. Enhancement was coincident with low energy images size in 9/18 (50%) patients, in 1/8 (5%) part of the enhancement, larger than the lesion in low energy images was due to a benign lesion (false positive) and 8/18 (45%) the size of the lesion that enhanced was truly larger than low energy images (histology proved). Because of this, surgery strategy was modified in 4 (22%) patients. There was radiologic complete response after neoadjuvant therapy and the surgical path report described a 2mm residual invasive carcinoma. There were no allergic reactions or other complications. A review of the published indications of the method was performed. Conclusions: Our initial experience and learning curve shows that CEM is safe with good clinical outcome (AU)

4.
Trop Dis Travel Med Vaccines ; 8(1): 20, 2022 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-35965345

RESUMO

BACKGROUND: The novel SARS-CoV-2, responsible for the COVID-19 pandemic, is the third zoonotic coronavirus since the beginning of the 21 first century, and it has taken more than 6 million human lives because of the lack of immunity causing global economic losses. Consequently, developing a vaccine against the virus represents the fastest way to finish the threat and regain some "normality." OBJECTIVE: Here, we provide information about the main features of the most important vaccine platforms, some of them already approved, to clear common doubts fostered by widespread misinformation and to reassure the public of the safety of the vaccination process and the different alternatives presented. METHODS: Articles published in open access databases until January 2022 were identified using the search terms "SARS-CoV-2," "COVID-19," "Coronavirus," "COVID-19 Vaccines," "Pandemic," COVID-19, and LMICs or their combinations. DISCUSSION: Traditional first-generation vaccine platforms, such as whole virus vaccines (live attenuated and inactivated virus vaccines), as well as second-generation vaccines, like protein-based vaccines (subunit and viral vector vaccines), and third-generation vaccines, such as nanoparticle and genetic vaccines (mRNA vaccines), are described. CONCLUSIONS: SARS-CoV-2 sequence information obtained in a record time provided the basis for the fast development of a COVID-19 vaccine. The adaptability characteristic of the new generation of vaccines is changing our capability to react to emerging threats to future pandemics. Nevertheless, the slow and unfair distribution of vaccines to low- and middle-income countries and the spread of misinformation are a menace to global health since the unvaccinated will increase the chances for resurgences and the surge of new variants that can escape the current vaccines.

5.
Int J Public Health ; 64(8): 1203-1214, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31559445

RESUMO

OBJECTIVES: Based on a life course perspective, we assessed the association between three types of social advantages and disadvantages accumulated across different life stages, with the number of self-reported chronic conditions among women aged 60 + in Chile, a Latin-American country with almost no reports on this matter. METHODS: We used a population-representative longitudinal survey (Chile's Social Protection Survey) with information about childhood conditions, economic mobility across life, educational attainment, late adulthood labor-force trajectories, and later-life health, of 2627 women aged 60+. We then used sequence and Poisson regression analyses to assess the effect of life course (dis)advantages over the number of chronic conditions in old age. RESULTS: Growing up in a poor household and experiencing downward economic mobility (especially among those with a non-poor childhood) increases the predicted number of chronic conditions in old age. By contrast, having a continuous and formal labor-force trajectory in late adulthood and higher educational attainment is associated with fewer chronic conditions later in life. CONCLUSIONS: Policy measures that seek to foster health prevention and health care among older women should consider how multiple exposures to social advantages/disadvantages during earlier stages of the life course could affect health in late life.


Assuntos
Doença Crônica/epidemiologia , Escolaridade , Nível de Saúde , Classe Social , Idoso , Idoso de 80 Anos ou mais , Envelhecimento , Chile , Emprego/estatística & dados numéricos , Feminino , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Análise de Regressão , Autorrelato , Inquéritos e Questionários
6.
Health Informatics J ; 25(4): 1661-1674, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30192686

RESUMO

Consumers are increasingly using social media to interact with other consumers about health conditions and treatment options. This study aimed to investigate the advantages and disadvantages of using social media for health-related purposes from the consumers' perspectives. Five focus groups with 36 Australian adults with a chronic condition and on medication were conducted, audio-recorded, transcribed verbatim, and thematically analysed. Consumers reported that social media was very convenient, for accessing health-related information and for peer engagement; user-friendly; improved their health knowledge; empowered them; and provided social and emotional support. The disadvantages included information overload, wasting time; negative feelings; doubts about online information credibility; and issues related to online interactions. Despite some disadvantages, health-related use of social media led consumers to feel supported, knowledgeable, and empowered. Consumers' motivation to keep accessing social media for health-related purposes opens up avenues for the delivery of services via social media.


Assuntos
Comportamento do Consumidor , Atenção à Saúde/normas , Percepção , Mídias Sociais/normas , Adulto , Atenção à Saúde/estatística & dados numéricos , Feminino , Grupos Focais/métodos , Humanos , Masculino , Pesquisa Qualitativa , Mídias Sociais/instrumentação , Mídias Sociais/estatística & dados numéricos , Vitória
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