Acta Medica Port
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Review
[The Impact of CFTR Modulating Therapy on Chronic Lung Infection in Patients with Cystic Fibrosis].
Cystic fibrosis is the most common lethal genetic disease in the white population, affecting approximately 80 000 people worldwide. It is an autosomal recessive, monogenic, and multisystemic disease, with over 2000 mutations described in the CFTR protein gene. The dysfunction of this protein leads to a decrease in the secretion of chlorine and bicarbonate, sodium hyperabsorption, and consequent water absorption, resulting in the thickening of secretions and accumulation of pathogens. ⋯ However, in up to 70% of patients, colonization is polymicrobial, with frequent isolation of S. aureus and P. aeruginosa, associated with Haemophilus influenzae or Streptococcus pneumoniae, as well as isolation of other bacterial agents, viruses, or fungi. In recent years, drugs modulating CFTR have been developed which have shown a positive effect on lung function, body mass index, exacerbation rate, chlorine concentration, and quality of life. Currently, four drugs are approved that act by improving the function or increasing the amount of protein produced and consequently the ion transport. [...].
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The recycling of used batteries has raised public health concerns as this activity is associated with occupational and environmental exposure to lead. We describe the case of a 26-year-old woman who experienced palpitations associated with headaches, fatigue and insomnia. Blood tests showed anemia (Hb 11.9 g/dL) and a lead concentration of 59 μg/dL. ⋯ The analytical study revealed a normalization of hemoglobin levels (12.2 g/dL) and a decrease in blood lead levels to 23.4 μg/dL. The health effects of lead exposure are nonspecific, and its diagnosis requires a high degree of suspicion. In this context, the collaboration between the Attending Physician and the Health and Safety Departments of companies is important.
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Multicenter Study
[Risk Factors for Delayed Discharge Due to Social Factors: A Retrospective Study].
The hospital setting faces a rate of bed occupation by patients whose discharge is limited by other factors apart from clinical needs. This urges the need for an early identification of the patients at risk of delayed discharge due to social factors in order to reduce expenses and to add value that converts itself into the patient health. The aim of this study was to identify the demographic and clinical factors that may be associated with delayed discharge. ⋯ Female sex, a prolonged clinical stay and diabetes mellitus were associated with a higher risk of delayed discharge, while heart failure and chronic kidney disease were associated with a reduced risk. These findings create a basis for a possible future multicentre study aimed at creating a clinical prediction rule to stratify the risk of delayed hospital discharge in the Portuguese population.