The COVID-19 pandemic has had a major impact on health care services, leading to a breakdown in public and private health systems worldwide. A major challenge was the scarcity of mechanical ventilators, which resulted...The COVID-19 pandemic has had a major impact on health care services, leading to a breakdown in public and private health systems worldwide. A major challenge was the scarcity of mechanical ventilators, which resulted in the use of anaesthesia devices for this purpose. However, they are quite different from mechanical ventilators used in Intensive Care Units and some adaptations, such as the use of high flow to reduce CO2 rebreathing, were necessary to ensure patient safety. The objective of this study was to present a mathematical formula and develop a tool that can be used to adjust the flow of oxygen and air in flow metres of anaesthesia devices that do not have oxygen analysers or these analysers are not operational. A literature review was conducted using the main health databases and libraries as research sources: PubMed, Virtual Health Library (VHL), SciELO, and Cochrane. The review included studies published in English, Spanish, and Portuguese. Animal studies were excluded. A total of 11 references were included to support this article.展开更多
BACKGROUND Hepatitis C virus(HCV)infection is responsible for a chronic liver inflammation,which may cause end-stage liver disease and hepatocellular carcinoma.Apolipoprotein E(protein:ApoE,gene:APOE),a key player in ...BACKGROUND Hepatitis C virus(HCV)infection is responsible for a chronic liver inflammation,which may cause end-stage liver disease and hepatocellular carcinoma.Apolipoprotein E(protein:ApoE,gene:APOE),a key player in cholesterol metabolism,is mainly synthesized in the liver and APOE polymorphisms may influence HCV-induced liver damage.AIM To determine whether APOE alleles affect outcomes in HCV-infected patients with liver cirrhosis following orthotopic liver transplantation(OLT).METHODS This was a cohort study in which 179 patients,both genders and aged 34-70 years,were included before or after(up to 10 years follow-up)OLT.Liver injury severity was assessed using different criteria,including METAVIR and models for endstage liver disease.APOE polymorphisms were analyzed by quantitative real-time polymerase chain reaction.RESULTS The APOE3 allele was the most common(67.3%).In inflammation severity of biopsies from 89 OLT explants and 2 patients in pre-transplant,the degree of severe inflammation(A3F4,0.0%)was significantly less frequent than in patients with minimal and moderate degree of inflammation(≤A2F4,16.2%)P=0.048,in patients carrying the APOE4 allele when compared to non-APOE4.In addition,a significant difference was also found(≤A2F4,64.4%vs A3F4,0.0%;P=0.043)and(A1F4,57.4%vs A3F4,0.0%;P=0.024)in APOE4 patients when compared to APOE3 carriers.The fibrosis degree of the liver graft in 8 of 91 patients and the lack of the E4 allele was associated with more moderate fibrosis(F2)(P=0.006).CONCLUSION Our results suggest that the E4 allele protects against progression of liver fibrosis and degree of inflammation in HCV-infected patients.展开更多
文摘The COVID-19 pandemic has had a major impact on health care services, leading to a breakdown in public and private health systems worldwide. A major challenge was the scarcity of mechanical ventilators, which resulted in the use of anaesthesia devices for this purpose. However, they are quite different from mechanical ventilators used in Intensive Care Units and some adaptations, such as the use of high flow to reduce CO2 rebreathing, were necessary to ensure patient safety. The objective of this study was to present a mathematical formula and develop a tool that can be used to adjust the flow of oxygen and air in flow metres of anaesthesia devices that do not have oxygen analysers or these analysers are not operational. A literature review was conducted using the main health databases and libraries as research sources: PubMed, Virtual Health Library (VHL), SciELO, and Cochrane. The review included studies published in English, Spanish, and Portuguese. Animal studies were excluded. A total of 11 references were included to support this article.
基金the National Council for Scientific and Technological Development,No.CNPqthe Coordination for the Improvement of Higher Education Personnel,No.CAPESthe Fundação Cearense de Apoio ao Desenvolvimento Científico e Tecnológico,No.FUNCAP.
文摘BACKGROUND Hepatitis C virus(HCV)infection is responsible for a chronic liver inflammation,which may cause end-stage liver disease and hepatocellular carcinoma.Apolipoprotein E(protein:ApoE,gene:APOE),a key player in cholesterol metabolism,is mainly synthesized in the liver and APOE polymorphisms may influence HCV-induced liver damage.AIM To determine whether APOE alleles affect outcomes in HCV-infected patients with liver cirrhosis following orthotopic liver transplantation(OLT).METHODS This was a cohort study in which 179 patients,both genders and aged 34-70 years,were included before or after(up to 10 years follow-up)OLT.Liver injury severity was assessed using different criteria,including METAVIR and models for endstage liver disease.APOE polymorphisms were analyzed by quantitative real-time polymerase chain reaction.RESULTS The APOE3 allele was the most common(67.3%).In inflammation severity of biopsies from 89 OLT explants and 2 patients in pre-transplant,the degree of severe inflammation(A3F4,0.0%)was significantly less frequent than in patients with minimal and moderate degree of inflammation(≤A2F4,16.2%)P=0.048,in patients carrying the APOE4 allele when compared to non-APOE4.In addition,a significant difference was also found(≤A2F4,64.4%vs A3F4,0.0%;P=0.043)and(A1F4,57.4%vs A3F4,0.0%;P=0.024)in APOE4 patients when compared to APOE3 carriers.The fibrosis degree of the liver graft in 8 of 91 patients and the lack of the E4 allele was associated with more moderate fibrosis(F2)(P=0.006).CONCLUSION Our results suggest that the E4 allele protects against progression of liver fibrosis and degree of inflammation in HCV-infected patients.
