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Cardiovascular Implications in Patients Infected with Covid-19 and the Importance of Social Isolation to Reduce Dissemination of the Disease.

新型冠状病毒肺炎感染患者的心血管影响和社会隔离对减少疾病传播的重要性。

  • 影响因子:1.00
  • DOI:10.36660/abc.20200243
  • 作者列表:"Costa JA","Silveira JA","Santos SCMD","Nogueira PP
  • 发表时间:2020-06-01
Abstract

:Respiratory symptoms, especially the development of severe acute respiratory distress syndrome, dominate the discussion and initial concerns of the population and health professionals. However, the cardiovascular system is greatly affected by these conditions and is often responsible for complications and mortality of these patients. In order to show the cardiovascular implications in patients infected with COVID-19 and the importance of social isolation as an alternative to curb the spread of the disease, a literature review was carried out based on 37 articles, in English, Portuguese and Spanish, available on Scielo and PubMed. The findings showed that cardiac complications associated with COVID-19 infection are similar to those produced by: severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and influenza. However, COVID-19 has a much greater and faster contamination and, unlike influenza, there is no vaccine or treatment available yet. In view of this, social isolation becomes a tool that can reduce and flatten the curve of cases and thus protect the people at higher risk, decreasing the chances of serious conditions related to the disease, potential deaths and the collapse of the country's health system. :Os sintomas respiratórios, principalmente o desenvolvimento de quadros de síndrome do desconforto respiratório agudo grave, dominam a discussão e as preocupações iniciais da população e dos profissionais de saúde. Entretanto, o sistema cardiovascular é bastante afetado por essas condições e, muitas vezes, é o responsável por complicações e mortalidade desses pacientes. Com o objetivo de mostrar as implicações cardiovasculares em pacientes infectados pela COVID-19 e a importância do isolamento social como alternativa de frear a disseminação da doença, foi realizada uma revisão da literatura com base em 37 artigos, nos idiomas inglês, português e espanhol, disponíveis na plataforma Scielo e PubMed. Os resultados mostraram que complicações cardíacas associadas à infecção pela COVID-19 são semelhantes às produzidas por: síndrome respiratória aguda grave (SARS), síndrome respiratória do Médio Oriente (MERS) e influenza. Contudo, a COVID-19 apresenta uma contaminação muito maior e mais rápida e, ao contrário da gripe por influenza, ainda não existe vacina disponível ou tratamento. Diante disso, o isolamento social passa a ser uma ferramenta que pode reduzir e achatar a curva de casos incidentes e assim preservar as pessoas que se enquadrem no grupo de risco, diminuindo as chances de quadros graves da doença, possíveis óbitos e o colapso no sistema de saúde do país.

摘要

: 呼吸道症状,特别是严重急性呼吸窘迫综合征的发展,主导了人口和卫生专业人员的讨论和最初关注。然而,心血管系统在很大程度上受到这些病症的影响,并且常常导致这些患者的并发症和死亡率。为了显示新型冠状病毒肺炎感染患者的心血管影响,以及社会隔离作为遏制疾病传播的替代方案的重要性,根据 37 篇文献进行了文献综述,英语、葡萄牙语和西班牙语版本,可在Scielo和PubMed上获得。调查结果显示,与新型冠状病毒肺炎感染相关的心脏并发症与严重急性呼吸综合征 (传染性非典型肺炎) 、中东呼吸综合征和流感产生的并发症相似。然而,新型冠状病毒肺炎的污染更大、更快,与流感不同,目前还没有疫苗或治疗方法。鉴于此,社会隔离成为一种工具,可以减少和展平病例曲线,从而保护风险较高的人,减少与疾病相关的严重疾病的机会,潜在的死亡和国家卫生系统的崩溃。 : Os sintomas respiratórios,principalmente o desenvolvimento de quadros de síndrome做desconforto respiratório agudo,dominam一个discussão e preocupações iniciais da população e dos profissionais de sa ú de图标.Entretanto,o sistema cardiovascular é bastante afetado por escondies es e,muitas vezes,é o respons á velpor compaction a ç es e mortalidade dss pacientes.Com o objetivo de mostrar as implicica ç çes cardiovasculares em pacientes infecteados pela新型冠状病毒肺炎e a important â ncia do isolamento social como alternativa de frear a advertia ç ã o da doen ç a,foi realizada uma revisi ã o da literatura com base em 37 artigos,nos idiomas ingl ê s,portugu ê s e espanhol,dispon í veis na plataforma Scielo e PubMed.Os resultados mostraram que comprica ç es escard í acas associadas à infeco pela新型冠状病毒肺炎s é semelhantes à s produzidas por: s í ndrome respirat ó ria aguda grave (传染性非典型肺炎),s í ndrome respirat ó ria do m é dio Oriente (MERS) e流感。Contudo,a新型冠状病毒肺炎apresenta uma compoma ã o muito maior e mais r á pida e,ao contr á rio da gripe por流感,ainda n ã o existe vacina disponi vel ou tratamento.Diante disso,o isolamento social passa a ser uma ferramenta que pode reduzir e achatar a curva de casos incidencetes e assim presvar as pessoas que se enquadrem no grupo de risco,diminuindo as chances de quadros graves da doen ç a,sp í veis ó bitos e o colapso no sistema de sa ú de do pa í s.

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影响因子:14.71
发表时间:2020-02-01
来源期刊:Nature immunology
DOI:10.1038/s41590-019-0571-2
作者列表:["Adrover JM","Aroca-Crevillén A","Crainiciuc G","Ostos F","Rojas-Vega Y","Rubio-Ponce A","Cilloniz C","Bonzón-Kulichenko E","Calvo E","Rico D","Moro MA","Weber C","Lizasoaín I","Torres A","Ruiz-Cabello J","Vázquez J","Hidalgo A"]

METHODS::The antimicrobial functions of neutrophils are facilitated by a defensive armamentarium of proteins stored in granules, and by the formation of neutrophil extracellular traps (NETs). However, the toxic nature of these structures poses a threat to highly vascularized tissues, such as the lungs. Here, we identified a cell-intrinsic program that modified the neutrophil proteome in the circulation and caused the progressive loss of granule content and reduction of the NET-forming capacity. This program was driven by the receptor CXCR2 and by regulators of circadian cycles. As a consequence, lungs were protected from inflammatory injury at times of day or in mouse mutants in which granule content was low. Changes in the proteome, granule content and NET formation also occurred in human neutrophils, and correlated with the incidence and severity of respiratory distress in pneumonia patients. Our findings unveil a 'disarming' strategy of neutrophils that depletes protein stores to reduce the magnitude of inflammation.

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翻译标题与摘要 下载文献
影响因子:2.81
发表时间:2020-01-05
DOI:10.3390/ijerph17010356
作者列表:["Yang LC","Suen YJ","Wang YH","Lin TC","Yu HC","Chang YC"]

METHODS::Pneumonia is a common respiratory infectious disease that involves the inflammation of the pulmonary parenchyma. Periodontal disease is widespread and correlated with pneumonia. However, the relationship between periodontal treatment and clinical infectious outcomes in patients with pneumonia has remained undetermined. The aim of this study was to investigate the association between periodontal treatment and the risk of pneumonia events in the Taiwanese population. A nationwide population-based cohort study was conducted using data from the Taiwanese National Health Insurance Research Database (NHIRD). A total of 49,400 chronic periodontitis patients who received periodontal treatment from 2001 to 2012 were selected. In addition, 49,400 healthy individuals without periodontal diseases were picked randomly from the general population after propensity score matching according to age, gender, monthly income, urbanization, and comorbidities. The Cox proportional hazard regression analysis was adopted to assess the hazard ratio (HR) of pneumonia between the periodontal treatment cohort and the comparison cohort. The average ages of the periodontal treatment and comparison groups were 44.25 ± 14.82 years and 44.15 ± 14.5 years, respectively. The follow up durations were 7.66 and 7.41 years for the periodontal treatment and comparison groups, respectively. We found 2504 and 1922 patients with newly diagnosed pneumonia in the comparison cohort and the periodontal treatment cohort, respectively. The Kaplan-Meier plot revealed that the cumulative incidence of pneumonia was significantly lower over the 12 year follow-up period in the periodontal treatment group (using the log-rank test, p < 0.001). In conclusion, this nationwide population-based study indicated that the patients with periodontal treatment exhibited a significantly lower risk of pneumonia than the general population.

翻译标题与摘要 下载文献
影响因子:2.89
发表时间:2020-04-01
DOI:10.1016/j.ijid.2020.01.038
作者列表:["Ngocho JS","Horumpende PG","de Jonge MI","Mmbaga BT"]

METHODS:OBJECTIVE:To describe the treatment of community-acquired pneumonia (CAP) in children under five years in Tanzania. METHODS:Between January and December 2017, children aged 2-59 months with chest radiography-confirmed CAP were enrolled. The parents were interviewed to collect information on the patients and home-based medication. Clinical information was derived from the patient files. Nasopharyngeal swab and blood samples were collected for isolation of the causative pathogens. Swab samples were analysed by quantitative PCR whereas blood samples were tested using BacT/Alert 3D. RESULTS:Overall, 109 children with CAP were included in this analysis. Provision of care to most children was delayed (median = 4.6 days). A quarter (26.6%) were given unprescribed/leftover antibiotics at home. Only one child had positive bacterial culture. Referrals were associated with nasopharyngeal carriage of Streptococcus pneumoniae (p = 0.003) and Haemophilus influenzae (p = 0.004). Of all admitted children, more than a quarter (n = 29) did not need to be hospitalised and inappropriately received injectable instead of oral antibiotics. CONCLUSION:We found high rates of home treatment, particularly with antibiotics. Appropriate health care was delayed for most children because of home treatment. Efforts are needed at the community level to improve awareness of antimicrobial resistance.

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肺炎方向

肺炎是指终末气道、肺泡和肺间质的炎症。可由细菌、病毒、真菌、寄生虫等致病微生物,以及放射线、吸入性异物等理化因素引起。临床主要症状为发热、咳嗽、咳痰、痰中带血,可伴胸痛或呼吸困难等。

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