Diss. (sammanfattning) Uppsala : Uppsala universitet, 2006. / Härtill 4 uppsatser.

Thesis (MHSc--Health Science) -- Auckland University of Technology, 2003. / Appendix B not included in e-thesis. Also held in print (128 leaves, 30 cm.) in Akoranga Theses Collection. (T 610.7361 SOH)

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Background: From October 2010 through February 2016, Arizona conducted surveillance for severe acute respiratory infections (SARI) among adults hospitalized in the Arizona-Mexico border region. There are few accurate mortality estimates in SARI patients, particularly in adults >= 65 years old. The purpose of this study was to generate mortality estimates among SARI patients that include deaths occurring shortly after hospital discharge and identify risk factors for mortality. Methods: Patients admitted to two sentinel hospitals between 2010 and 2014 who met the SARI case definition were enrolled. Demographic data were used to link SARI patients to Arizona death certificates. Mortality within 30 days after the date of admission was calculated and risk factors were identified using logistic regression models. Results: Among 258 SARI patients, 47% were females, 51% were white, non-Hispanic and 39% were Hispanic. The median age was 63 years (range, 19 to 97 years) and 80% had one or more pre-existing health condition; 9% died in hospital. Mortality increased to 12% (30/258, 30% increase) when electronic vital records and a 30-day post-hospitalization time frame were used. Being age >= 65 years (OR = 4.0; 95% CI: 1.6-9.9) and having an intensive care unit admission (OR = 7.4; 95% CI: 3.0-17.9) were independently associated with mortality. Conclusion: The use of electronic vital records increased SARI-associated mortality estimates by 30%. These findings may help guide prevention and treatment measures, particularly in high-risk persons in this highly fluid border population.

Orientador: Ricardo de Lima Zollner / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-19T21:14:23Z (GMT). No. of bitstreams: 1 Vian_BrunaScharlack_M.pdf: 1879886 bytes, checksum: d9b52c103c4a6cca51810138e9c47e14 (MD5) Previous issue date: 2012 / Resumo: A rinite alérgica (RA) é definida como uma inflamação da mucosa nasal, resultando em sintomas nasais que incluem rinorréia, obstrução, prurido e espirros. O fator de crescimento neural (NGF) está envolvido na fisiopatologia de inflamação alérgica. Soluções salinas nasais em diversas concentrações têm sido usadas para prevenir ou reduzir sintomas alérgicos, porém as concentrações ideais das soluções de cloreto de sódio nasal ainda não estão bem estabelecidas na literatura disponível. O objetivo desse estudo foi avaliar o efeito das soluções salinas: isotônica (ISO), hipertônica 3% (HIPER) e agua destilada (HIPO) em pacientes com RA persistente, comparando os escores clínicos dos sintomas nasais, avaliação do escore olfativo e a expressão gênica de NGF como marcador inflamatório do conteúdo celular nasal e considerando temperatura e umidade nos diferentes períodos em que utizaram as soluções. Trinta (30) pacientes com diagnóstico de RA persistente iniciaram o estudo, porem apenas 13 terminaram. Os pacientes foram divididos em 3 grupos aleatorizados que utilizaram as 3 soluções: ISO, HIPER e HIPO em 3 períodos diferentes (P1, P2 e P3). Os critérios clínicos de avaliação dos sintomas eram avaliados por meio de "Questionário Validado", onde somava-se o total do escore dos sintomas nasais (TESN). Para a avaliação do sintoma olfato era aplicado um escore olfativo de 0 a 8 com diluições de essência de eucalipto. Foi realizada coleta de material da mucosa nasal para o estudo da expressão gênica de NGF por meio de Reação de Polimerase em Cadeia (PCR). Os resultados observados neste estudo foram que no P1, os pacientes apresentaram melhora do TESN (p=0.004), quando comparada com a HIPER. Tanto o grupo que iniciou o tratamento com a solução ISO (p= 0,056), quanto o grupo que iniciou com HIPO (p= 0,063) tiveram uma tendência de melhora quando comparada com a HIPER. Todos os grupos no P1 apresentaram melhora do escore olfativo. O grupo que iniciou com a solução HIPER mostrou valores de expressão de NGF significativamente maiores (p=0,023). Conclui-se então, que as soluções salinas podem ser utilizadas como tratamento adjuvante na RA, pois melhorou os sintomas e melhorou o escore olfativo, porém a solução HIPER aumentou expressão de NGF na mucosa nasal / Abstract: Allergic rhinitis (AR) is defined as inflammation of the nasal mucosa, resulting in nasal symptoms including rhinorrhea, obstruction, itching and sneezing. Neural growth factor (NGF) is involved in the pathophysiology of allergic inflammation. Nasal saline solutions, at various concentrations, have been used to prevent or reduce allergic symptoms, but the ideal concentration of nasal sodium chloride solutions are not well established in the literature. The objective were to evaluate the effect of salt solutions such as isotonic (ISO), hypertonic (3% NaCl - HYPER) and hypotonic (sterile distilled water - HYPO) in patients with persistent allergic rhinitis, comparing clinical scores of nasal symptoms and olfactory score, as well as NGF expression as an inflammatory marker of nasal cell content. Thirteen (13) patients of thirty (30) with diagnosed persistent AR were divided into three randomized groups that used three solutions: ISO, HYPO and HYPER, during three periods (P1, P2 and P3). Clinical evaluation criteria of symptoms were determined by a validated questionnaire that evaluated the total nasal symptom score (TNSS). Nasal mucosa material was collected to analyze NGF expression assessed by the Polymerase Chain Reaction (PCR). The results were: patients showed an improvement in TNSS (p = 0.004) during the first period. The group that began treatment using the ISO solution (p = 0.056), as well the group that started using the HYPO (p = 0.063) showed a trend of improvement in TNSS, when compared with the HYPER group. All groups showed improvement in olfactory score during de first period. With regard to NGF gene expression, the group treated with the HYPER solution showed significantly higher levels (p=0.023) of expression compared with patients treated with the other nasal solutions. The conclusion was that the salt solutions may be used as adjuvant therapy in AR, due to the fact that they improve symptoms and olfactory score. Hyper saline solution can increase the expression of NGF in nasal mucosa / Mestrado / Clinica Medica / Mestre em Clinica Medica

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The recent study by Cunningham, Lewis, Curnow, Glazner, and Massie [1] on the attitudes of respiratory physicians and clinic coordinators towards cystic fibrosis (CF) carrier screening drew several unsupported conclusions because the α level of 0.05 was not corrected for the large number of hypothesis tests conducted, leading to a Type 2 error and the acceptance of hypotheses that were likely false [2].

A recent study by Leonard, Lebecque, Dingemanse, and Leal [1] tested the effect of Miglustat, an alpha inhibitor on the cystic fibrosis conductance regulator gene using total chloride secretion in the nasal epithelium as the key variable estimated from basal nasal potential differences. The conclusion was drawn that “There was no evidence of a treatment effect on any nasal potential difference variable.” This conclusion may not be correct because of a slight misinterpretation of their statistical results. There also is a question of whether longer exposure periods than 8 days would have produced a more pronounced effect.

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No description available.