scholarly journals Effectiveness of Telephone Monitoring in Primary Care to Detect Pneumonia and Associated Risk Factors in Patients with SARS-CoV-2

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1548
Author(s):  
Jose Miguel Baena-Díez ◽  
Isabel Gonzalez-Casafont ◽  
Sara Cordeiro-Coelho ◽  
Soledad Fernández-González ◽  
Migdalia Rodríguez-Jorge ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Healthcare ◽  
Severe Disease ◽  
Health Care Practitioner ◽  
Post Discharge ◽  
Healthcare Center ◽  
Telephone Monitoring ◽  
Associated Risk Factors ◽  
Primary Healthcare Center

Improved technology facilitates the acceptance of telemedicine. The aim was to analyze the effectiveness of telephone follow-up to detect severe SARS-CoV-2 cases that progressed to pneumonia. A prospective cohort study with 2-week telephone follow-up was carried out March 1 to May 4, 2020, in a primary healthcare center in Barcelona. Individuals aged ≥15 years with symptoms of SARS-CoV-2 were included. Outpatients with non-severe disease were called on days 2, 4, 7, 10 and 14 after diagnosis; patients with risk factors for pneumonia received daily calls through day 5 and then the regularly scheduled calls. Patients hospitalized due to pneumonia received calls on days 1, 3, 7 and 14 post-discharge. Of the 453 included patients, 435 (96%) were first attended to at a primary healthcare center. The 14-day follow-up was completed in 430 patients (99%), with 1798 calls performed. Of the 99 cases of pneumonia detected (incidence rate 20.8%), one-third appeared 7 to 10 days after onset of SARS-CoV-2 symptoms. Ten deaths due to pneumonia were recorded. Telephone follow-up by a primary healthcare center was effective to detect SARS-CoV-2 pneumonias and to monitor related complications. Thus, telephone appointments between a patient and their health care practitioner benefit both health outcomes and convenience.

Abstract P026: Cardiovascular Risk Factors, Lifestyle And Social Determinants: Results From A Population-based Cross-sectional Study In Brazil (laparc Study)

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Tomás de Souza Mello ◽  
Beatriz D Marinho ◽  
Rafael B Azevedo ◽  
Lucas Antequera ◽  
Pedro Julio Velasco ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Healthcare ◽  
Sedentary Lifestyle ◽  
Demographic Data ◽  
Inverse Association ◽  
Socioeconomic Indicators ◽  
Cross Sectional ◽  
Healthcare Center ◽  
Low Education ◽  
Primary Healthcare Center

Objective: To evaluate the relationship between the main cardiovascular (CV) risk factors and socioeconomic indicators in a population of young adults provided by a Primary Healthcare Center in a large urban area of Brazil. Methods: Cross-sectional population study that included adults aged between 20- and 50-years old provided by a Primary Healthcare Center in Rio de Janeiro, Brazil. Demographic data (gender and age), socioeconomic data (education level, occupation, employment), CV risk factors (smoking, sedentary lifestyle, obesity, hypertension, diabetes, dyslipidemia) were recorded. The metabolic profile was evaluated through laboratory tests. Those who studied up to high school were considered poorly educated. Results: A total of 604 individuals were enrolled [39% male, mean age: 38.8 ± 8,9 years]. The median of schooling was 12 years. In addition, 288 individuals had high schooling, of which 44.5% were male. A total of 130 individuals did not study or work. Women with low education had a higher risk of smoking, hypertension, and obesity, with no difference regarding labor or study activities. Otherwise, men with low education had higher risk of sedentary lifestyle and hypertension. Among men, not working or studying increased the risk of smoking and hypertension. Conclusions: We found an inverse association between socioeconomic status and the prevalence of CV risk factors. Women are more affected by low schooling, while men are more affected by their working occupation. The study suggests that socioeconomic factors influence the CV risk, affecting men and women differently, pointing to the need for public policies to reverse this situation.

Abstract P142: Metabolically Healthy Obesity In A Young Adult Population Provided By A Primary Healthcare Center In Brazil (LAPARC Study)

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Beatriz D Marinho ◽  
Tomás de Souza Mello ◽  
Rafael B Azevedo ◽  
Daniella Barbalho ◽  
Clara Muguet ◽  
...  
Keyword(s):  
Risk Factors ◽  
Young Adult ◽  
Primary Healthcare ◽  
Adult Population ◽  
Abdominal Circumference ◽  
Metabolically Healthy Obesity ◽  
Healthcare Center ◽  
Young Adult Population ◽  
Metabolically Healthy ◽  
Primary Healthcare Center

Background: Obesity is increasing in younger populations, and is associated with a high cardiovascular (CV) risk, however, it is not clear whether metabolically healthy obesity (MHO) may have a lower CV risk or if it is just an earlier stage of the disease. Objective: To evaluate the prevalence and CV risk factors associated with MHO in a young adult population provided by a Primary Healthcare Center in a large urban area of Brazil. Methods: A cross-sectional population study for CV risk assessment in adults aged 20-50 years old provided by a Primary Healthcare Center in Rio de Janeiro, Brazil. Demographic, anthropometric data and CV risk factors were recorded. All underwent office blood pressure (OBP) measurements, laboratory evaluation (lipid and glycemic profile). Obesity was defined as a BMI ≥ 30 kg/m2 and MHO are those who have less than 3 of the following criteria: hypertension, diabetes, total cholesterol ≥ 200 mg/dL, HDL<40 mg/dL (men) and 50 mg/dL (women), triglycerides>150 mg/dL and increased waist circumference. Results: A total of 632 individuals were evaluated (60% female; mean age 37 ± 9 years). The prevalence of obesity was 25% (161 of 632 individuals), of which 73% (117 of 161 individuals) were classified as MHO. Obese individuals are older, with a higher prevalence of physical inactivity (51% vs 41%, p=0.03), hypertension (44% vs 19%, p<0.001), dyslipidemia (50% vs 36%, p=0.002) and diabetes (7% vs 2%, p=0.001) with higher systolic OBP. MHO compared to unhealthy ones are significantly younger and smoke less. Despite being obese, they have lower BMI (33.6 vs 35.2 kg/m2, p=0.02) and abdominal circumference (102 vs 110 cm, p=0.03), with lower diastolic BP. Conclusions: MHO was more prevalent in this young adult population and seems to have a lower CV risk, however it is not clear whether these younger and less obese individuals are only at an earlier stage of the disease. Perhaps the CV diseases onset is postponed for a few years. Even so, these individuals should not be excluded from public health policies as a form of primary prevention.

scholarly journals Management of a case of COVID-19 with adrenal crisis at a semi-urban primary healthcare center

2020 ◽  
pp. 122-126
Author(s):  
Chinmay Saha Podder ◽  
Nandini Chowdhury ◽  
Wasim Md Mohosin Ul Haque
Keyword(s):  
Primary Healthcare ◽  
Social Stigma ◽  
Severe Disease ◽  
Limited Resource ◽  
Adrenal Crisis ◽  
Steroid Use ◽  
Healthcare Center ◽  
Resource Setting ◽  
Increased Risk ◽  
Primary Healthcare Center

Prolonged steroid use and the resultant adrenal insufficiency pose an increased risk of severe disease in patients with COVID-19. We describe here a case of Covid-19 with adrenal crisis in an elderly man at a semiurban primary healthcare center. He and his family were forced to leave their home because of being infected with SARS-CoV-2. He was managed for adrenal crisis at a limited resource setting with a good outcome. This case also highlights the importance of social stigma related to COVID-19 in Bangladesh. Birdem Med J 2020; 10, COVID Supplement: 122-126

scholarly journals RISK FACTORS ASSOCIATED WITH NEONATAL HYPOGLYCEMIA

2006 ◽  
Vol 13 (04) ◽  
pp. 687-690
Author(s):  
MUNIR AKMAL LODHI ◽  
GHULAM SHABBIR ◽  
NASIR ALI SHAH
Keyword(s):  
Risk Factors ◽  
Low Birthweight ◽  
Birth Asphyxia ◽  
Neonatal Hypoglycemia ◽  
Factors Associated ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Associated Risk Factors ◽  
Glucose Estimation

Objectives: Recurrent episodes of neonatal hypoglycemia are strongly associated with long termphysical and neuro-developmental deficits. (1) Moreover in neonates hypoglycemia can be overlooked as it may havenonspecific symptoms only. (2) This study was therefore carried out to analyse the risk factors associated with neonatalhypoglycemia and to evaluate the risk factors which have predictive value in its diagnosis. .Design: Based case controlstudy. Period: Six months from January 2005 to June 2005. Setting CMH Pano Aqil. Material and Methods: 385newborns were studied. Newborns of both civilians as well as military personnel were included in the study. 11newborns were excluded. Out of remaining 347 patients 101 were found to be hypoglycemia. Five risk factors (low birthweight, Birth Asphyxia, Neonatal sepsis, Meconeum aspiration syndrome delayed feeding ) strongly and independentlypredicated the risk of hypoglycemia. Results: The most common associated risk factor was low birth weight (47.47%)followed by delayed feeding (46.29%). Blood sampling for glucose estimation was done at birth / admission at 6 hours,12 hours, 24 hours and 48 hours. Test was initially performed by glucometer, the reading which were confirmed bylaboratory testing in border line case. Conclusions: In neonates with associated risk factors it is cost affective to carryout blood glucose levels at the time of birth and follow up readings taken as indicated by clinical progress later on.

scholarly journals A COVID-19 Patient with Simultaneous Renal Infarct, Splenic Infarct and Aortic Thrombosis during the Severe Disease

Healthcare ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 150
Author(s):  
Georgios Mavraganis ◽  
Sofia Ioannou ◽  
Anastasios Kallianos ◽  
Gianna Rentziou ◽  
Georgia Trakada
Keyword(s):  
Abdominal Pain ◽  
Severe Disease ◽  
Severe Abdominal Pain ◽  
Antithrombotic Treatment ◽  
Post Discharge ◽  
Treatment Information ◽  
High Incidence ◽  
Thrombotic Complications ◽  
Renal Infarct

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been associated with a high incidence of arterial and venous thrombotic complications. However, thromboembolic events in unusual sites such as limb and visceral arterial ischemia are reported rarely in the literature. Herein, we describe a rare case of a patient with severe coronavirus disease 2019 (COVID-19) infection who experienced severe abdominal pain during the hospitalization and presented simultaneously renal artery, splenic artery and vein as well as aortic thrombi despite prophylactic antithrombotic treatment. Information about his follow-up post discharge is also provided. This case report raises significant clinical implications regarding the correct dose of antithrombotic treatment during the acute phase of the severe COVID-19 infection and highlights the need for incessant vigilance in order to detect thrombosis at unusual sites as a possible diagnosis when severe abdominal pain is present in severe COVID-19 patients.

scholarly journals URBAN-RURAL DISPARITY: THE UTILIZATION OF PRIMARY HEALTHCARE CENTERS AMONG ELDERLY IN EAST JAVA, INDONESIA

2019 ◽  
Vol 7 (2) ◽  
pp. 147 ◽  
Author(s):  
Ratna Dwi Wulandari ◽  
Agung Dwi Laksono
Keyword(s):  
Primary Healthcare ◽  
Rural Areas ◽  
Health Research ◽  
Urban Areas ◽  
The Elderly ◽  
Utilization Of Health Services ◽  
Healthcare Center ◽  
Urban Rural ◽  
Primary Healthcare Centers ◽  
Primary Healthcare Center

Background: Urban always attracts investors to invest. Health facilities in urban areas are growing rapidly compared to villages. This condition is estimated to contribute to the disparity of urban-rural areas in the utilization of health services. Studying the utilization of health services is a way to evaluate the performance of the health care system through its output.Aim: This study analyzed the urban-rural disparity in the utilization of primary healthcare center by the elderly.Method: This study used in the 2013 Basic Health Research raw data. The 2013 Basic Health Research was designed as a cross-sectional survey. With the multi-stage cluster random sampling method, 25,813 elderly people in East Java Province participated. Data were analyzed using Multinomial Logistic Regression tests.Results: Elderly people in urban areas have a better probability of outpatient use of 1.208 than those living in rural areas (OR 1.208; 95% CI 1.057-1.380). The elderly who have a primary school and under education have the possibility of 1.558 times more utilizing outpatients in primary healthcare centers than the elderly who have college education levels (OR 1.558; 95% CI 1.001-2.424).Conclusion: There was a disparity between urban and rural areas in the utilization of outpatient primary healthcare centers in East Java by the elderly. Policymakers in East Java are recommended to improve facilities and infrastructure of the primary healthcare centers in rural areas by paying attention to the results of this study.Keywords: elderly, urban-rural disparities, primary healthcare center, healthcare utilization, inpatient-outpatient. 

scholarly journals Prevalence, incidence and associated risk factors of STIs during pregnancy in South Africa

2020 ◽  
pp. sextrans-2020-054631
Author(s):  
Dorothy Chiwoniso Nyemba ◽  
Andrew Medina-Marino ◽  
Remco P H Peters ◽  
Jeffrey D Klausner ◽  
Phuti Ngwepe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
Birth Outcomes ◽  
Syndromic Management ◽  
Younger Age ◽  
Pregnancy And Birth Outcomes ◽  
Adverse Pregnancy ◽  
Associated Risk Factors ◽  
Pregnancy And Birth

ObjectiveSTIs during pregnancy increase adverse pregnancy and birth outcomes and may increase HIV risk. STI syndromic management is standard of care in South Africa. Our study evaluated the prevalence and incidence of STIs in pregnant women and the associated risk factors.MethodsWe combined data from two prospective observational studies of pregnant women enrolled while attending their first antenatal clinic (ANC) visit in Tshwane District and Cape Town. Women ≥18 years were tested at first ANC visit and at their first postpartum visit for Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis using Xpert assays (Cepheid, USA). We evaluated the prevalence and incidence of STI and the associated risk factors using multivariable regression models.ResultsWe enrolled 669 pregnant women, 64% (n=427) from Tshwane District and 36% (n=242) from Cape Town; 80% (n=534) were women living with HIV (WLHIV) and 20% (n=135) without HIV. At enrolment, 37% (n=250) were diagnosed with at least one STI, of which 76% (n=190) were asymptomatic. STI prevalence was 40% (n=213) in WLHIV and 27% (n=37) in women without HIV (p=0.01). Baseline STI infection was associated with younger age (OR=0.95 per year, 95% CI 0.92 to 0.98), higher gestational age (adjusted OR (aOR)=1.03 per week, 95% CI 1.00 to 1.05), single relationship status (aOR=1.53, 95% CI 1.09 to 2.15) and HIV status (aOR=1.86, 95% CI 1.17 to 2.95). Of 419 participants with no STI at baseline, 21 had an incident STI during follow-up, with a mean follow-up time of 140 days. The incidence rate of STI during pregnancy and early post partum was 15 infections per 100 women-years (95% CI 9 to 23). Younger age was associated with STI incidence.ConclusionOur study shows high prevalence and incidence of STIs in pregnancy, especially in WLHIV, demonstrating the need for STI screening in ANC to prevent adverse pregnancy and birth outcomes. Most STI cases were asymptomatic and would have gone untreated with syndromic management. Aetiological STI screening is urgently needed to reduce the burden of STIs in pregnancy.

scholarly journals Severe pulmonary tuberculosis complicated with insidious pulmonary thromboembolism: a case report and literature review

2019 ◽  
Vol 49 (4) ◽  
pp. 644-650
Author(s):  
Lili Huang ◽  
Chunyang Yin ◽  
Xiaoyan Gu ◽  
Xiaojun Tang ◽  
Xia Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Case Report ◽  
Pulmonary Thromboembolism ◽  
Severe Disease ◽  
Intravenous Thrombolysis ◽  
Interventional Therapy ◽  
Enhanced Ct ◽  
Prophylactic Use

Abstract Pulmonary thromboembolism (PTE) is an acute and severe disease with high mortality, which is prone to be misdiagnosed or ignored especially when complicated with tuberculosis (TB). Even though TB has been considered as a risk factor for PTE, there is rare report of TB with PTE worldwide. Which TB patients are more susceptible to PTE is still not clear. Here, we described a case report of PTE with pulmonary TB in a 28-year-old man, who had no risk factors for pulmonary thrombosis at admission and developed a medium-high PTE after initiating anti-TB therapy. After local thrombolysis with interventional therapy and sequential intravenous thrombolysis, combined with long-term anticoagulation, the PTE of the patient disappeared. At follow-up of 4 months, the patient was re-examined with chest enhanced CT and no obvious emboli was found. We emphasize that acute or severe TB infection should be included in the thromboembolism risk assessment and prophylactic use of anticoagulants may be considered even if there are no other obvious risk factors. Interventional therapy is a good option for thrombolysis treatment if hospital condition permits.

Changes in Voice- and Swallowing-Related Symptoms After Thyroidectomy: One-Year Follow-Up Study

2018 ◽  
Vol 127 (3) ◽  
pp. 171-177 ◽  
Author(s):  
Young Min Park ◽  
Kyung Ho Oh ◽  
Jae-Gu Cho ◽  
Seung-Kuk Baek ◽  
Soon-Young Kwon ◽  
...  
Keyword(s):  
Risk Factors ◽  
Symptom Relief ◽  
Temporal Changes ◽  
Rehabilitation Programs ◽  
Significant Difference ◽  
One Year ◽  
Associated Risk Factors ◽  
Changes Over Time ◽  
Over Time

Objective: We analyzed the changes in voice- and swallowing-related symptoms that occurred over time in patients who underwent thyroidectomy and identified any associated risk factors. Methods: One hundred and three patients who underwent thyroidectomy were enrolled. Results: The mean thyroidectomy voice-related questionnaire (TVQ) score before surgery was 12.41 ± 12.19; it significantly increased to 28.24 ± 18.01 ( P < .001) 1 month postoperatively, decreased to 24.02 ± 17.30 ( P = .014) and 20.66 ± 15.29 ( P = .023) 3 and 6 months postoperatively, respectively. It was continuously decreased to 18.83 ± 14.63 twelve months postoperatively. The temporal changes in TVQ scores between patients who underwent total thyroidectomy or lobectomy were significantly different. There was a statistically significant difference in the temporal changes in TVQ according to whether neck dissection was performed. The temporal changes in TVQ in patients with and without extrathyroidal extension were significantly different. Conclusions: Voice- and swallowing-related discomfort in patients who received thyroidectomy showed dynamic changes over time. There was a significant difference in the degree of change according to clinicopathological factors. Patients with these risk factors may benefit from appropriate patient education and various rehabilitation programs for symptom relief.

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