BackgroundThe prevalence of drug–drug interactions (DDIs) in hospital settings is variable, and elderly patients are considered a high risk population for DDIs. There are no systematic reviews describing the prevalence of DDIs in hospitalised elderly patients.ObjectivesTo assess and summarise the available data on the prevalence of DDIs in hospitalised elderly patients and to describe which drugs, drug classes and drug combinations are most commonly involved in DDIs.Data sourceA systematic electronic literature search was conducted on Medline/PubMed, Embase, Lilacs, SciElo, Web of Science, Cinahl, Scopus, Cochrane, OpenGrey, Capes Thesis Bank, OasisBR, OpenAire and abstracts from scientific events, without limitation on language or period of publication. Study selection was completed on 21 September 2018.Study eligibility criteria, participants and interventionsOriginal observational studies that reported the prevalence of actual or potential DDIs during hospitalisation in patients aged 60 years or older were included. The main outcome measure was prevalence of DDIs and number of DDIs per patient. Subgroup analysis was performed in studies that reported the prevalence of DDIs in geriatric units.Study appraisal and synthesis methodsStudy quality was assessed using the Agency for Healthcare Research and Quality methodological checklist for cross sectional and prevalence studies.Results34 studies were included, involving 9577 patients. The prevalence of DDIs ranged from 8.34% to 100%. In studies conducted in geriatric units, the prevalence ranged from 80.5% to 90.5%. The number of DDIs per patient ranged from 1.2 to 30.6. Single drugs most commonly involved in DDIs were furosemide, captopril, warfarin and dipyrone. Drug classes mostly involved were potassium sparing diuretics and angiotensin converting enzyme inhibitors.LimitationsThe main limitation is the heterogeneity between the included studies that precluded a meta-analysis. Several different methods were used to identify DDIs, majorly, and potential DDIs. Few studies have reported measures to control the quality of the collected data.Conclusions and implications of key findingsThe prevalence of DDIs ranged widely, and the variation may reflect differences in the conditions of the elderly patients and level of attention (or complexity of care), as well as methodological differences, especially the methods and/or software used to identify DDIs.Systematic review registration numberCRD42018096720

AimsThis study aimed to identify the symptoms associated with early stage SARS-CoV-2 (COVID-19) infections in healthcare professionals (HCPs) using both clinical and laboratory data.MethodsA total of 1297 patients, admitted between 18 March and 8 April 2020, were stratified according to their risk of developing COVID-19 using their responses to a questionnaire designed to evaluate symptoms and risk conditions.ResultsAnosmia/hyposmia (p<0.0001), fever (p<0.0001), body pain (p<0.0001) and chills (p=0.001) were all independent predictors for COVID-19, with a 72% estimated probability for detecting COVID-19 in nasopharyngeal swab samples. Leucopenia, relative monocytosis, decreased eosinophil values, C reactive protein (CRP) and platelets were also shown to be significant independent predictors for COVID-19.ConclusionsThe significant clinical features for COVID-19 were identified as anosmia, fever, chills and body pain. Elevated CRP, leucocytes under 5400×109/L and relative monocytosis (>9%) were common among patients with a confirmed COVID-19 diagnosis. These variables may help, in the absence of reverse transcriptase PCR tests, to identify possible COVID-19 infections during pandemic outbreaks.SummaryFrom 19 March to 8 April 2020, 1297 patients attended the Polyclinic Piquet Carneiro for COVID-19 detection. HCP data were analysed, and significant clinical features were anosmia, fever, chills and body pain. Elevated CRP, leucopenia and monocytosis were common in COVID-19.

RESUMOObjetivo: Identificar as evidências relacionadas ao uso/estudo da Classificação das Intervenções de Enfermagem (NIC) na prática clínica, em pesquisas realizadas por enfermeiros brasileiros. Métodos: Revisão integrativa de literatura, com busca em bases de dados eletrônicas, realizada entre março e abril de 2009. Foram incluídas dez produções completas que evidenciam o uso/estudo da NIC, realizadas por enfermeiros brasileiros, publicadas em português, inglês ou espanhol, em periódicos nacionais ou internacionais, sem intervalo temporal. Resultados: A análise dos dez artigos, todos de nível 5 de evidência, possibilitou a categorização de quatro linhas de estudo: associação com outras classificações, aplicação a determinados diagnósticos, utilização em situações clínicas específicas e validação de protocolo/guia de condutas de enfermagem. Conclusão: A dificuldade do manuseio da classificação, a falta de conhecimento e a autonomia profissional foram os principais achados. São lacunas de conhecimento, a escassez de estudos de validação de intervenções e a análise de resultados da utilização das classificações na prática clínica. Descritores: Cuidados de enfermagem/classificação; Processos de enfermagem/classificação; Enfermeiros; Brasil ABSTRACT Objective: To identify evidence related to the use of the Nursing Interventions Classification in clinical practice, as identified in nursing research within Brazil. Methods: Integrative review of literature was conducted between March and April 2009, using electronic databases. The sample included research demonstrating the use / research of NIC, conducted by Brazilian nurses, published in Portuguese, English or Spanish, in national or international journals, for all available publication years. Results: Ten articles were selected which met level 5 evidence, allowing the categorization of four lines of study: association with other classifications, application to specific diagnoses, use in specific clinical situations, and validation protocol / guiding nursing care. Conclusion: The difficulty in the managing NIC, lack of knowledge and professional autonomy were the main findings. There are knowledge gaps, lack of validation studies on interventions, and a lack of analysis of results from the use of NIC in clinical practice. Keywords: Nursing care/classification; Nursing process/classification; Nursing; Brazil RESUMENObjetivo: Identificar las evidencias relacionadas al uso/estudio de la Clasificación de las Intervenciones de Enfermería (NIC) en la práctica clínica, en investigaciones realizadas por enfermeros brasileños. Método: Revisión integrativa de literatura, con búsqueda en bases de datos electrónicas, realizada entre marzo y abril del 2009. Fueron incluidas diez producciones completas que evidencian el uso/estudio de la NIC, realizadas por enfermeros brasileños, publicadas en portugués, inglés o español, en periódicos nacionales o internacionales, sin intervalo temporal. Resultados: El análisis de los diez artículos, todos del nivel 5 de evidencia, posibilitó la ...

Aims: This study aimed to identify the symptoms associated with early-stage SARS-CoV-2 (COVID-19) infections in healthcare professionals (HCP) using both clinical and laboratory data. Methods: A total of 1,297 patients, admitted between March 18 and April 8, 2020, were stratified according to their risk of developing COVID-19 using their responses to a questionnaire designed to evaluate symptoms and risk conditions. Results: Anosmia/hyposmia (p <0.0001), fever (p<0.0001), body pain (p<0.0001), and chills (p=0.001) were all independent predictors for COVID-19, with a 72% estimated probability for detecting COVID-19 in nasopharyngeal swab samples. Leukopenia, relative monocytosis, decreased eosinophil values, CRP, and platelets were also shown to be significant independent predictors for COVID-19. Conclusions: The significant clinical features for COVID-19 were identified as anosmia, fever, chills, and body pain. Elevated CRP, leukocytes under 5,400 x 109/L, and relative monocytosis (>9%) were common among patients with a confirmed COVID-19 diagnosis. These variables may help, in the absence of RT-PCR tests, to identify possible COVID-19 infections during pandemic outbreaks.