Objetivo: Avaliar as características, evolução e desfecho dos pacientes coinfectados por COVID-19 e tuberculose (TB). Metodologia: A fim de responder a pergunta norteadora “Quais os riscos da coinfecção por COVID-19 e tuberculose?”, foi realizada uma revisão integrativa da literatura, qualitativa, com abordagem descritiva, nas bases de dados Google Scholar, PubMed, Cochrane Library, SciELO e LILACS, utilizando os descritores “COVID-19”, “Tuberculosis” e “Co-infection”. Foram critérios de inclusão: artigo disponível na íntegra, publicado em 2020, nos idiomas português, inglês e/ou espanhol. De exclusão artigos sem relação com o tema, com foco em ferramentas estatísticas, resumos isolados, capítulos de livros, editoriais, artigos de revisão, fichas técnicas, teses, dissertações e trabalhos de conclusão de curso. Resultados: Foram incluídos 8 artigos. A maioria dos pacientes coinfectados foram do sexo masculino, com média de idade de 47,19 anos. Os sintomas mais relatados foram febre, tosse, dispneia e cefaleia. As principais alterações laboratoriais incluíram elevação de proteína C reativa, velocidade de hemossedimentação, D-dímero e fibrinogênio. Achados imaginológicos como opacificações, derrame pleural, “árvore em brotamento”, vidro fosco, cavitações, atelectasias e espessamento do septo lobar foram frequentes. A coinfecção esteve mais atrelada a casos severos da doença e a letalidade foi de até 33,3%. Socialmente, a coinfecção repercute em dificuldades em diagnóstico diferencial, morbidade em grupos vulneráveis e dificuldade de acesso a tratamento em cenário pandêmico. Conclusão: Alguns estudos divergiram acerca da letalidade, porém foi possível observar uma tendência à associação de gravidade do curso clínico nos pacientes coinfectados.
Objective: To analyze the clinical profile of obese patients with COVID-19 in ambulatory care during the first wave of the pandemic. Methods: A retrospective observational study conducted in an outpatient setting in Aracaju/SE, Brazil. The patients with COVID-19 received medical care in a referral center from April to August 2020 and were followed remotely. Clinical data was analyzed using Jamovi 1.2.27. Results: Of 1,134 patients with COVID-19, 288 (25.4%) were obese, 59.7% were women. Hypertension, diabetes, dyslipidemia, and chronic kidney disease were more frequent in the obese group. Dyspnea and diarrhea were more frequent in obese individuals, while odynophagia, nausea, and vomiting were more common in non-obese individuals. Attending physicians prescribed more antibiotics, ivermectin, corticosteroids, and heparin for obese patients. Hospital admission (6.6% vs. 3.1%; p=0.008) and use of oxygen therapy (5.1% vs. 2.1%; p=0.011) were more frequent in the obesity group. Obesity was independently associated with hospital admission in multivariate analysis (OR: 2.561, 95% CI 1.352 - 4.853; p=0.004). The lethality rate was higher in obese individuals (2.1% vs. 0.7%; p=0.049). Conclusion: In this outpatient cohort of COVID-19 patients, there were more comorbidities among obese individuals. Despite the low frequency of unfavorable outcomes overall, obesity increased the risk of hospital admission and there were more deaths among patients with obesity.
Introduction: Preference has been given to minimally invasive approaches to the intracranial metastases, and alternative methods should be developed especially for environments with budget constraints. Objectives: This paper aims to describe a technique using a application for smartphone and a pair of compasses in approaches to intracranial metastases in a budget-constrained environment. Methods: Two cases are reported describing a technique of microsurgical treatment of brain metastases in a minimally invasive approach using a smartphone application that allows the planning of approaches to intracranial metastases. The NeuroKeypoint app is available in the App Store and Google Play Store. The compass Trident 9001 was used in association. Results: The incisions for craniotomies were marked at the indicated points according to the Neurokeypoint application. A single point marking was prioritized, corresponding to the center of the intended craniotomy. Intraoperative ultrasound was done before corticectomy and the location of the lesion was confirmed. The lesions were easily localized in both cases and both craniotomies were considered as adequate. Conclusion: The NeuroKeypoint application provides a low-cost and widely available alternative, making it accessible to a wide range of services.
Todos os direitos garantidos. Este é um livro publicado em acesso aberto, que permite uso, distribuição e reprodução em qualquer meio, sem restrições desde que sem fins comerciais e que o trabalho original seja corretamente citado. Este trabalho está licenciado com uma Licença Creative Commons Internacional (CC BY-NC 4.0).
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.