Home Telehealth Uptake and Continued Use Among Heart Failure and Chronic Obstructive Pulmonary Disease Patients: a Systematic Review

Background Home telehealth has the potential to benefit heart failure (HF) and chronic obstructive pulmonary disease (COPD) patients, however large-scale deployment is yet to be achieved. Purpose The aim of this review was to assess levels of uptake of home telehealth by patients with HF and COPD and the factors that determine whether patients do or do not accept and continue to use telehealth. Methods This research performs a narrative synthesis of the results from included studies. Results Thirty-seven studies met the inclusion criteria. Studies that reported rates of refusal and/or withdrawal found that almost one third of patients who were offered telehealth refused and one fifth of participants who did accept later abandoned telehealth. Seven barriers to, and nine facilitators of, home telehealth use were identified. Conclusions Research reports need to provide more details regarding telehealth refusal and abandonment, in order to understand the reasons why patients decide not to use telehealth

Tuberculose e blastomicose laríngeas: relato de três casos e revisão de literatura Tuberculosis and blastomycosis of the larynx: report of three cases and review of literature

As doenças granulomatosas da laringe apresentam quadros polimórficos de difícil diagnóstico pelo exame clínico. São patologias que apresentam evolução favorável se o tratamento efetivo for introduzido precocemente, evitando complicações. Muitas vezes, a primeira manifestação destas patologias dá-se a nível da laringe, portanto devem ser lembradas no diagnóstico diferencial de doenças inflamatórias. Relatamos o caso de três pacientes que procuraram nosso Serviço com queixa de disfonia, sem alteração ao exame físico geral, sendo diagnosticada após a investigação tuberculose e blastomicose laríngeas.<br>The granulomatosis diseases of the larynx have different clinical manifestations, which difficult the clinical diagnosis. When the treatment is early introduced, the result is satisfactory. The first manifestation of granulomatosis diseases can occur in larynx, and it always has to be remembered among laryngeal inflammatory diseases. We reported three cases were symptom was hoarseness, and after investigation the diagnosis was tuberculosis and blastomycosis of the larynx. The evaluation and management are discussed

Correlação entre índice de massa corporal e circunferência da cintura em crianças Correlación entre índice de masa corporal y circunferencia de la cintura en niños Correlation between body mass index and waist circumference in children

OBJETIVO: Estabelecer uma correlação entre a circunferência da cintura e o Índice de Massa Corporal (IMC) na determinação do excesso de peso e distribuição de gordura em crianças de escolas públicas de Fortaleza - CE. MÉTODOS: Trata-se de um estudo transversal, realizado em 12 escolas da rede da pública da cidade de Fortaleza- CE. Participaram 727 crianças de ambos os sexos, com idade variando entre 6 a 11 anos. A coleta de dados ocorreu de março a junho de 2008. RESULTADOS: Os resultados do inquérito mostraram que, de acordo com o IMC,11,4% das crianças encontravam-se em sobrepeso, 6,6% eram obesas e 30,9% apresentaram obesidade central. CONCLUSÃO: Nem toda criança obesa apresentava obesidade central, demonstrando que uma só medida antropométrica não é eficaz na determinação do padrão de gordura na infância.<br>OBJETIVO: Establecer una correlación entre la circunferencia de la cintura y el Índice de Masa Corporal (IMC) en la determinación del exceso de peso y distribución de grasa en niños de escuelas públicas en Fortaleza - CE. MÉTODOS: Se trata de un estudio transversal, realizado en 12 escuelas de la red pública de la ciudad de Fortaleza- CE. Participaron 727 niños de ambos sexos, con edad que varió de 6 a 11 años. La recolección de datos ocurrió de marzo a junio de 2008. RESULTADOS: Los resultados de la encuesta mostraron que, de acuerdo con el IMC, 11,4% de los niños se encontraban con sobrepeso, 6,6% eran obesos y 30,9% presentaron obesidad central. CONCLUSIÓN: No todos los niños obesos presentaban obesidad central, demostrando que solo una medida antropométrica no es eficaz para determinar el estándar de adiposidad en la infancia.<br>OBJECTIVE: To establish a correlation between waist circumference and Body Mass Index (BMI) and to determine overweight and fat distribution in children from public schools in Fortaleza - CE. METHODS: This is a cross-sectional study conducted in 12 public schools in the city of Fortaleza-CE. The participants were 727 children of both genders, aged 6-11 years. Data collection occurred from March to June 2008. RESULTS: The survey results showed that, according to BMI, 11.4% of children were overweight, 6.6% were obese and 30.9% had central obesity. CONCLUSION: Not all obese children had central obesity, showing that only one anthropometric measure is not effective in determining the pattern of fat in childhood