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The need for smoking cessation counselling and nicotine with- drawal therapy for hospitalised patients: A smoking point preva- lence study at Groote Schuur Hospital, Cape Town, South Africa 住院病人对戒烟咨询和尼古丁抑制疗法的需求:南非开普敦格罗特舒尔医院的吸烟点预测研究
Q3 Medicine Pub Date : 2024-07-04 DOI: 10.7196/ajtccm.2024.v30i2.1360
G. Soin, J. Kok, A. Allie, Q. Bhawoodien, K. Dheda, A. Geragotellis, K. Mulisa, A. Sibi, T. Tarwa, F. Leone, R. Van Zyl-Smit
Background. South Africa has high tobacco-attributable mortality and a smoking prevalence of 32.5% in males and 25.6% in females. There are limited data on smoking prevalence and desire to quit in hospitalised patients, who have limited access to smoking cessation services.Objectives. To determine smoking prevalence and the extent of nicotine withdrawal symptoms, using a hospital-wide inpatient survey.Methods. A 1-day point prevalence survey was conducted at Groote Schuur Hospital, Cape Town. All wards except the haematology isolation, active labour and psychiatry lock-up wards were evaluated. Smoking status, withdrawal symptoms and desire to quit were established.Results. Smoking status was confirmed in 85.8% of inpatients (n=501/584), of whom 31.9% (n=160) were current smokers; 43.5% (n=101/232) of male and 21.9% (n=59/269) of female inpatients were smokers. Documentation and confirmation of smoking status was highest in the maternity wards (100%) and lowest in the surgical wards (79.6%) and intensive care units (70.0%). Smoking prevalence ranged from 47.6% in male surgical patients to 15.2% in maternity patients. Of the smokers, 54.5% reported being motivated to quit, with a median (interquartile range) Fagerström test for nicotine dependence score of 4 (2 - 6), and 31.4% reported moderate to severe cravings to smoke, highest in the surgical wards.Conclusion. Smoking prevalence was higher in hospitalised patients than in the local general population. Many inpatients were not interested in quitting; however, a third had significant nicotine withdrawal symptoms. All inpatients who are active smokers should be identified and given universal brief smoking cessation advice. Patients with severe withdrawal symptoms should be allowed to smoke outside, and nicotine withdrawal pharmacotherapy should be provided to those who are bedbound or express a desire to stop smoking during the current admission.
背景。南非因吸烟导致的死亡率很高,男性吸烟率为 32.5%,女性为 25.6%。有关住院病人吸烟率和戒烟意愿的数据十分有限,而住院病人获得戒烟服务的机会有限。通过一项全院住院病人调查,确定吸烟率和尼古丁戒断症状的程度。在开普敦格罗特舒尔医院进行了为期一天的点吸烟率调查。除血液隔离病房、待产病房和精神病禁闭病房外,所有病房均接受了评估。调查确定了吸烟状况、戒断症状和戒烟意愿。85.8%的住院患者(n=501/584)的吸烟状况得到确认,其中31.9%(n=160)的患者目前是吸烟者;43.5%(n=101/232)的男性住院患者和21.9%(n=59/269)的女性住院患者是吸烟者。产科病房的吸烟情况记录和确认率最高(100%),外科病房(79.6%)和重症监护病房(70.0%)最低。吸烟率从男性外科病人的 47.6% 到产科病人的 15.2% 不等。在吸烟者中,54.5%的人表示有戒烟动机,法格斯特伦尼古丁依赖测试的中位数(四分位之间)为4(2 - 6)分,31.4%的人表示有中度到重度的吸烟渴望,其中外科病房的吸烟渴望最高。住院患者的吸烟率高于当地普通人群。许多住院病人对戒烟不感兴趣,但有三分之一的病人有明显的尼古丁戒断症状。应识别所有积极吸烟的住院病人,并向他们普及简短的戒烟建议。对于戒断症状严重的患者,应允许其在室外吸烟,对于卧床不起或在入院期间表示希望戒烟的患者,应提供尼古丁戒断药物治疗。
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引用次数: 0
Tracheal necrosis after sandwich immunotherapy and stereotactic body radiotherapy for lung cancer 肺癌夹层免疫疗法和立体定向体放疗后的气管坏死
Q3 Medicine Pub Date : 2024-07-04 DOI: 10.7196/ajtccm.2024.v30i2.1620
S. M. Bennji, B. Jayakrishnan, Z. Al- Hashami, L. Mula-Hussain, R. B. Telugu
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引用次数: 0
Severe lower respiratory tract infections are associated with human adenovirus in hospitalised children in a high HIV prevalence area 艾滋病毒高发区住院儿童的严重下呼吸道感染与人类腺病毒有关
Q3 Medicine Pub Date : 2024-07-04 DOI: 10.7196/ajtccm.2024.v30i2.1208
N. Marafungana, FC MB ChB, K. Naidoo, PhD Gounder, MMed Virol Viro, R. Masekela, MMed Paed MB BCh, Cert Pulmonology, PhD Paed
Background. Viral causes of lower respiratory tract infections (LRTIs) are associated with increased mortality in children aged <5 years (U5). Human adenovirus (HAdV) has been associated with severe LRTI; however, its relationship with HIV and malnutrition in South Africa (SA) is not understood.Objectives. To identify the prevalence of and factors associated with HAdV LRTIs in hospitalised U5 childen.Methods. Clinical and viral data on U5 children hospitalised with severe LRTI from January 2018 to June 2020 at King Edward VIII Hospital, Durban, SA, including results of a multiplex polymerase chain reaction (PCR) panel assay for respiratory viruses, were retrieved from inpatient files and laboratory databases and retrospectively analysed. Standard descriptive statistics and Pearson’s χ2, Fisher’s exact and Mann-Whitney tests were used to determine significant associations with HAdV LRTI.Results. Among the 206 viral assays analysed (15.6% of all LRTI admissions), HAdV was the most common virus identified. The cohort had a median (interquartile range) age of 5 (2 - 13) months, 47.3% had perinatal HIV exposure, and 34.5% had severe acute malnutrition (SAM). No seasonal pattern with HAdV could be demonstrated. SAM and prematurity were significant risk factors for readmission, and perinatal HIV exposure was a significant risk factor for presence of multiple viruses on analysis of a respiratory specimen. Detection of HAdV was not associated with an increased risk of requiring oxygen or ventilatory support.Conclusion. HAdV was the most common virus found on analysis of multiplex PCR panel results in children hospitalised with severe LRTI in SA, where high rates of HIV exposure may result in increased susceptibility to viral co-infections. The role of HAdV as a cause of severe LRTI in SA infants, who have high rates of HIV exposure, requires greater scrutiny.
背景。病毒引起的下呼吸道感染(LRTIs)与 5 岁以下儿童(U5)死亡率的增加有关。人类腺病毒(HAdV)与严重的下呼吸道感染有关,但其与南非(SA)艾滋病和营养不良的关系尚不清楚。确定住院的 5 岁以下儿童中 HAdV LRTIs 的发病率和相关因素。从住院病人档案和实验室数据库中检索了南非德班爱德华八世国王医院2018年1月至2020年6月因严重LRTI住院的U5儿童的临床和病毒数据,包括呼吸道病毒的多重聚合酶链反应(PCR)面板检测结果,并进行了回顾性分析。采用标准描述性统计、Pearson's χ2、Fisher's 精确检验和 Mann-Whitney 检验来确定与 HAdV LRTI 的显著关联。在分析的 206 项病毒检测中(占所有 LRTI 住院病例的 15.6%),HAdV 是最常见的病毒。组群的年龄中位数(四分位数间距)为 5(2 - 13)个月,47.3% 在围产期接触过 HIV,34.5% 患有严重急性营养不良 (SAM)。HAdV没有季节性特征。严重急性营养不良和早产是再入院的重要风险因素,围产期感染艾滋病毒是呼吸道标本分析中出现多种病毒的重要风险因素。检测出HAdV与需要氧气或呼吸支持的风险增加无关。HAdV是南澳大利亚州因严重LRTI住院的儿童在多重PCR检测结果分析中发现的最常见病毒。HAdV是南澳婴儿严重LRTI的病因之一,而南澳婴儿的HIV暴露率很高,因此需要对HAdV的作用进行更深入的研究。
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引用次数: 0
A rare cause of acute post-intubation respiratory failure. 插管后急性呼吸衰竭的罕见病因。
Q3 Medicine Pub Date : 2024-07-04 eCollection Date: 2024-01-01
L C Costa, J Fernandes, N Príncipe, J A Paiva
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引用次数: 0
Determining the aetiology of lower respiratory tract illness in children 确定儿童下呼吸道疾病的病因
Q3 Medicine Pub Date : 2024-07-04 DOI: 10.7196/ajtccm.2024.v30i2.2378
L. Thaver, H. J. Zar
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引用次数: 0
Foreign body aspiration in children: Challenges, insights, and pathways forward 儿童异物吸入:挑战、启示和前进之路
Q3 Medicine Pub Date : 2024-07-04 DOI: 10.7196/ajtccm.2024.v30i2.2380
P. Goussard, E. Eber
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引用次数: 0
Smoking cessation for hospitalised inpatients: Butt where do we begin? 为住院病人戒烟:但我们从哪里开始?
Q3 Medicine Pub Date : 2024-07-04 DOI: 10.7196/ajtccm.2024.v30i2.2379
N. Singh, C. F. N. Koegelenberg
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引用次数: 0
Tracheobronchial foreign body aspiration in children in Soweto, South Africa: A retrospective descriptive study 南非索韦托儿童气管支气管异物吸入症:回顾性描述研究
Q3 Medicine Pub Date : 2024-07-04 DOI: 10.7196/ajtccm.2024.v30i2.1145
A. Moola, MB BCh, C. Verwey, FC MB ChB, Cert Pulmonology, PhD Paed, Mabaso, K. Mopeli, Z. Dangor
Background. Airway foreign bodies are a common cause of accidental death in children. Tracheobronchial foreign body aspiration (FBA) can result in severe immediate and long-term complications if the foreign body is not identified and removed. Little is known about the burden of tracheobronchial FBA in the Soweto area, south of Johannesburg, South Africa.Objectives. To describe the burden and clinical characteristics of tracheobronchial FBA in hospitalised children in a tertiary-level hospital in Johannesburg.Methods. This was a retrospective, single-centre, descriptive study of children aged <10 years who presented to Chris Hani Baragwanath Academic Hospital from 1 January 2011 to 31 December 2020. Children with FBA were identified from the paediatric pulmonology and paediatric surgery databases using the relevant International Statistical Classification of Diseases and Related Health Problems, 10th revision (ICD-10), codes (T17.4 and T17.5). Clinical and radiological data were extracted from medical records and the databases.Results. Forty-seven children with FBA were identified during the study period. Overall, the incidence of FBA among children aged <10 years of age was 1.42 per 100 000 person-years (95.0% confidence interval 1.04 - 1.88). FBA occurred more commonly in males (66.0%; n=31), and the mean (standard deviation) age at presentation was 68 (28.2) months. Most of the children (42.6%) were in the 7 - <10-year age group, followed by the 5 - <7-year age group (27.7%). Chronic respiratory symptoms were reported in one-third of the children, and a history of witnessed FBA was reported in only 59.6% of cases. Inorganic foreign bodies (n=29; 61.7%) were aspirated more commonly than organic foreign bodies; these included metal objects such as pins or springs (21.3%), toy parts (17.0%), pen or pencil lids/ stoppers (12.8%) and plastic objects (6.4%).Conclusion. Our study highlights the fact that tracheobronchial FBA is prevalent in school-aged children, and public safety campaigns targeted at this age group are warranted. Furthermore, to prevent sequelae, a high index of suspicion in required in children with respiratory symptoms that fail to respond to appropriate therapy.
背景。气道异物是儿童意外死亡的常见原因。气管支气管异物吸入(FBA)如不及时发现和清除,可导致严重的直接和长期并发症。在南非约翰内斯堡南部的索韦托地区,人们对气管支气管异物吸入症的发病率知之甚少。描述约翰内斯堡一家三级甲等医院住院儿童气管支气管异物感的发病率和临床特征。这是一项回顾性、单中心、描述性研究,研究对象是2011年1月1日至2020年12月31日期间在克里斯-哈尼-巴拉夸那思学术医院就诊的10岁以下儿童。研究人员使用相关的《疾病和有关健康问题的国际统计分类》第 10 版(ICD-10)代码(T17.4 和 T17.5),从儿科肺病学和儿科外科数据库中识别出患有 FBA 的儿童。从病历和数据库中提取了临床和放射学数据。研究期间共发现 47 名患有 FBA 的儿童。总体而言,小于10岁儿童的FBA发病率为每10万人年1.42例(95.0%置信区间为1.04 - 1.88)。FBA多发于男性(66.0%;n=31),发病时的平均年龄(标准差)为68(28.2)个月。大多数患儿(42.6%)的年龄在 7 - <10 岁之间,其次是 5 - <7 岁年龄组(27.7%)。三分之一的儿童有慢性呼吸道症状,仅有59.6%的病例有亲眼目睹异物的病史。无机异物(n=29;61.7%)的吸入率高于有机异物;这些异物包括金属物品,如别针或弹簧(21.3%)、玩具部件(17.0%)、钢笔或铅笔盖/笔塞(12.8%)和塑料物品(6.4%)。我们的研究强调了一个事实,即气管支气管FBA在学龄儿童中很普遍,因此有必要针对这一年龄组开展公共安全宣传活动。此外,为防止后遗症,对于出现呼吸道症状且经适当治疗无效的儿童,需要高度怀疑。
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引用次数: 1
The impact of the COVID-19 pandemic on lung cancer presentation at a high-volume tertiary referral centre in South Africa COVID-19 大流行对南非一家大型三级转诊中心肺癌就诊情况的影响
Q3 Medicine Pub Date : 2024-07-04 DOI: 10.7196/ajtccm.2024.v30i2.1031
I. Fredericks, E. Irusen, B. Allwood, C. F. N. Koegelenberg
Background. The COVID-19 pandemic had a significant impact on health services globally. Cancer diagnosis and treatment was one of the services most frequently reported to be disrupted. Several international studies showed a marked reduction in the number of new lung cancer cases.Objectives. To assess the impact of the COVID-19 pandemic on lung cancer diagnosis at a high-volume tertiary referral centre in South Africa.Methods. A retrospective audit was conducted of all patients with primary lung cancer who were presented at the multidisciplinary oncology meeting at Tygerberg Hospital, Cape Town, from January 2018 to December 2021, and the incidence of lung cancer was compared between two cohorts: one prior to and one during the COVID-19 pandemic. We collected data on patient demographics, as well as performance status. A combined panel staged all patients.Results. During the COVID-19 pandemic there was a relative reduction of 46% in the frequency of lung cancer, from a mean of 25.6 cases per month to 13.9. Patients referred during the COVID-19 pandemic had statistically better performance status (75.0% v. 25.0% with performance status 0 - 2; p=0.01) and were more likely to have adenocarcinoma (49.7% v. 41.1%; p=0.02) than those referred before the pandemic. The proportion of potentially curable lung cancer at presentation (i.e. stages I - IIIA) did not differ between the two cohorts.Conclusion. The COVID-19 pandemic resulted in a substantial decrease in the number of new lung cancers diagnosed. Patients who were diagnosed with lung cancer during the pandemic had better performance status and were more likely to have adenocarcinoma. No impact on the proportion of potential curable disease was noted.
背景。COVID-19 大流行对全球医疗服务产生了重大影响。癌症诊断和治疗是最常被报道中断的服务之一。一些国际研究表明,肺癌新病例的数量明显减少。评估 COVID-19 大流行对南非一家高流量三级转诊中心肺癌诊断的影响。我们对2018年1月至2021年12月期间在开普敦泰格贝格医院多学科肿瘤学会议上就诊的所有原发性肺癌患者进行了回顾性审计,并对两个队列的肺癌发病率进行了比较:一个队列在COVID-19大流行之前,另一个队列在COVID-19大流行期间。我们收集了患者的人口统计学数据以及表现状况。联合小组对所有患者进行了分期。在 COVID-19 大流行期间,肺癌发病率相对下降了 46%,从平均每月 25.6 例降至 13.9 例。与大流行前相比,在COVID-19大流行期间转诊的患者在统计学上表现更佳(75.0%对25.0%表现为0 - 2;P=0.01),更有可能患有腺癌(49.7%对41.1%;P=0.02)。两组患者发病时可能治愈的肺癌比例(即 I - IIIA 期)并无差异。COVID-19大流行导致新诊断出的肺癌数量大幅下降。大流行期间确诊的肺癌患者表现较好,更有可能患有腺癌。潜在可治愈疾病的比例没有受到影响。
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引用次数: 0
A case of septic pulmonary embolism associated with hand sepsis in an immunocompetent host 一例免疫功能正常者手部败血症并发脓毒性肺栓塞病例
Q3 Medicine Pub Date : 2024-07-04 DOI: 10.7196/ajtccm.2024.v30i2.1014
T. Zobair, I. Sihlahla, D. B. Arnolds, R. I. Raine, G. Calligaro
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引用次数: 0
期刊
African Journal of Thoracic and Critical Care Medicine
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