BackgroundLong-term exposure to particulate matter (PM) has essential and profound effects on human health, but most current studies focus on high-income countries. Evidence of the correlations between PM and health effects in low- and middle-income countries (LMICs), especially the risk factor PM1 (particles < 1 mu m in size), remains unclear. ObjectiveTo explore the effects of long-term exposure to particulate matter on the morbidity and mortality of cardiovascular and respiratory diseases in LMICs. MethodsA systematic search was conducted in the PubMed, Web of Science, and Embase databases from inception to May 1, 2022. Cohort studies and case-control studies that examine the effects of PM1, PM2.5, and PM10 on the morbidity and mortality of cardiovascular and respiratory diseases in LMICs were included. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias. Outcomes were analyzed via a random effects model and are reported as the relative risk (RR) with 95% CI. ResultsOf the 1,978 studies that were identified, 38 met all the eligibility criteria. The studies indicated that long-term exposure to PM2.5, PM10, and PM1 was associated with cardiovascular and respiratory diseases: (1) Long-term exposure to PM2.5 was associated with an increased risk of cardiovascular morbidity (RR per 1.11 mu g/m(3), 95% CI: 1.05, 1.17) and mortality (RR per 1.10 mu g/m(3), 95% CI: 1.06, 1.14) and was significantly associated with respiratory mortality (RR 1.31, 95% CI: 1.25, 1.38) and morbidity (RR 1.08, 95% CI: 1.02, 1.04); (2) An increased risk of respiratory mortality was observed in the elderly (65+ years) (RR 1.21, 95% CI: 1.00, 1.47) with long-term exposure to PM2.5; (3) Long-term exposure to PM10 was associated with cardiovascular morbidity (RR 1.07, 95% CI 1.01, 1.13), respiratory morbidity (RR 1.43, 95% CI: 1.21, 1.69) and respiratory mortality (RR 1.28, 95% CI 1.10, 1.49); (4) A significant association between long-term exposure to PM1 and cardiovascular disease was also observed. ConclusionsLong-term exposure to PM2.5, PM10 and PM1 was all related to cardiovascular and respiratory disease events. PM2.5 had a greater effect than PM10, especially on respiratory diseases, and the risk of respiratory mortality was significantly higher for LMICs than high-income countries. More studies are needed to confirm the effect of PM1 on cardiovascular and respiratory diseases.

Objective: to evaluate the cost-effectiveness of point-of-care leukocyte analyzers to aid in the diagnosis of airway infections in the SUS.Method: this is a cost-effectiveness study using a deterministic model developed from a decision tree.Results: the use of devices to perform diagnostic tests at the point of treatment has become increasingly popular and accepted around the world in view of the increased demand for care and the need to reduce the time it takes to return exam results to optimization of outcomes. After the Roll Back of the decision tree, the most cost-effective strategy was a white blood cell count-driven clinical investigation using the point-of-care analyzer to guide antibiotic prescribing.Conclusion: Evidence suggests that the use of POC analyzers for WBC counts and differentials at the point of care is a cost-effective alternative as part of a strategy to aid in the diagnosis and therapeutic management of cases of non-specific acute respiratory infections.

Research indicates that air pollution is a risk factor of an increased occurrence of diseases. However, evidence is limited on the effects of the pollution index on disease and whether temperature modifies the effects. The objectives were (i) to explore the effects of the Air Pollution Index (API) and specific indices for pollutants (PM10, NO2, and SO2) on respiratory emergency department (ED) visits in Beijing and (ii) to investigate whether temperature modified the effects of main air pollutants on respiratory ED visits. A quasi-Poisson generalized additive model was employed to examine the association of API and indices for pollutants with respiratory disease. Bivariate response surface model and stratification model (cold days, moderately cold days, moderately hot days, and hot days) were used to analyze the modification effects of temperature on air pollution and respiratory disease. The results showed that (i) the effects of API on respiratory diseases were similar to the index for PM(10)in Beijing. (ii) API and PM(10)were associated with increased respiratory ED visits on cold days and moderately cold days. Furthermore, the effects of PM(10)on respiratory disease on moderately cold days [Relative risk (RR) = 1.006 per 10 mu g/m(3), 95% CI 1.002-1.009] were stronger than on cold days (RR = 1.004 per 10 mu g/m(3), 95% CI 1.000-1.008). (iii) PM10(API) had a greater impact on children aged 10 to 17 years and females on moderately cold days, while the elderly had an increased risk of respiratory disease to PM10(RR = 1.008 per 10 mu g/m(3), 95% CI 1.002-1.013) and API (RR = 1.013 per 10, 95% CI 1.004-1.022) on cold days. In conclusion, temperature can modify the association between API and respiratory morbidity. A stronger correlation existed between PM(10)and respiratory diseases on moderately cold days, while the effects of cold days were less than that attributable to moderately cold days.

INTRODUCTION: Millions of people suffer from obstructive respiratory conditions globally. Including videogames in rehabilitation programs can be an interesting alternative to traditional programs or a complementary activity. OBJECTIVE: To explore the use of videogames in the treatment of patients with obstructive respiratory diseases. METHODS: A systematic literature search was performed to identify randomized clinical trials evaluating the effects of videogames on health outcomes in patients with respiratory obstructive diseases. The following databases were searched: PubMed, Web of Science, ScienceDirect, and Scopus. The methodological quality of the studies included was assessed with the Downs and Black quality assessment method. RESULTS: Nine articles were included, of which three used videogames as physical training methods and managed to improve exercise capacity, strength, quality of life, and symptoms. The remaining six articles used videogames to educate patients about the disease and showed slight improvements in knowledge of the disease and use of medication. CONCLUSION: The results of this review show that videogames are a very useful complementary therapy. They can contribute to enhance rehabilitation programs, as they improve exercise capacity, muscle strength, quality of life, severity, control, and knowledge of the disease. Videogames should be supervised by a professional so that programs can be tailored to patients, proposing different activities in the game and controlling the correct performance, and generating an increase in adherence to treatment.