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1.
J Perinat Med ; 48(9): 892-899, 2020 Nov 26.
Artigo em Inglês | MEDLINE | ID: mdl-32892181

RESUMO

The global spread of the SARS-CoV-2 virus during the early months of 2020 was rapid and exposed vulnerabilities in health systems throughout the world. Obstetric SARS-CoV-2 disease was discovered to be largely asymptomatic carriage but included a small rate of severe disease with rapid decompensation in otherwise healthy women. Higher rates of hospitalization, Intensive Care Unit (ICU) admission and intubation, along with higher infection rates in minority and disadvantaged populations have been documented across regions. The operational gymnastics that occurred daily during the Covid-19 emergency needed to be translated to the obstetrics realm, both inpatient and ambulatory. Resources for adaptation to the public health crisis included workforce flexibility, frequent communication of operational and protocol changes for evaluation and management, and application of innovative ideas to meet the demand.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Hospitais/estatística & dados numéricos , Obstetrícia/métodos , Pandemias , Pneumonia Viral/epidemiologia , Complicações Infecciosas na Gravidez/virologia , COVID-19 , Infecções por Coronavirus/complicações , Infecções por Coronavirus/terapia , Cuidados Críticos/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Administração Hospitalar , Humanos , Recém-Nascido , Cidade de Nova Iorque/epidemiologia , Obstetrícia/estatística & dados numéricos , Equipamento de Proteção Individual/estatística & dados numéricos , Admissão e Escalonamento de Pessoal , Pneumonia Viral/complicações , Pneumonia Viral/terapia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/terapia , SARS-CoV-2 , Capacidade de Resposta ante Emergências/organização & administração , Capacidade de Resposta ante Emergências/estatística & dados numéricos
2.
Orphanet J Rare Dis ; 16(1): 367, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34412683

RESUMO

BACKGROUND: In classical phenylketonuria (PKU) phenylalanine (Phe) accumulates due to functional impairment of the enzyme phenylalanine hydroxylase caused by pathogenic variants in the PAH gene. PKU treatment prevents severe cognitive impairment. Blood Phe concentration is the main biochemical monitoring parameter. Between appointments and venous blood sampling, Austrian PKU patients send dried blood spots (DBS) for Phe measurements to their centre. Coronavirus disease-19 (COVID-19), caused by the SARS CoV-2 virus, was classified as a pandemic by the World Health Organization in March 2020. In Austria, two nationwide lockdowns were installed during the first and second pandemic wave with variable regional and national restrictions in between. This retrospective questionnaire study compared the frequency of Phe measurements and Phe concentrations during lockdown with the respective period of the previous year in children and adolescents with PKU and explored potential influencing factors. RESULTS: 77 patients (30 female, 47 male; mean age 12.4 [8-19] years in 2020) from five centres were included. The decline of venous samples taken on appointments in 2020 did not reach significance but the number of patients with none or only one DBS tripled from 4 (5.2%) in 2019 to 12 (15.6%) in 2020. Significantly more patients had a decline than a rise in the number of DBS sent in between 2019 and 2020 (p < 0.001; Chi2 = 14.79). Especially patients ≥ 16 years sent significantly less DBS in 2020 (T = 156, p = 0.02, r = 0.49). In patients who adhered to DBS measurements, Phe concentrations remained stable. Male or female sex and dietary only versus dietary plus sapropterin treatment did not influence frequency of measurements and median Phe. CONCLUSION: During the COVID pandemic, the number of PKU patients who stopped sending DBS to their metabolic centre increased significantly, especially among those older than 16 years. Those who kept up sending DBS maintained stable Phe concentrations. Our follow-up system, which is based on DBS sent in by patients to trigger communication with the metabolic team served adherent patients well. It failed, however, to actively retrieve patients who stopped or reduced Phe measurements.


Assuntos
COVID-19 , Fenilcetonúrias , Adolescente , Áustria , Criança , Controle de Doenças Transmissíveis , Gerenciamento Clínico , Feminino , Humanos , Masculino , Pandemias , Fenilcetonúrias/epidemiologia , Estudos Retrospectivos , SARS-CoV-2
3.
Asia Pac J Public Health ; 27(2): NP713-33, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-22087040

RESUMO

The failure to contain pandemic influenza A(H1N1) 2009 in Mexico has shifted global attention from containment to mitigation. Limited surveillance and reporting have, however, prevented detailed assessment of mitigation during the pandemic, particularly in low- and middle-income countries. To assess pandemic influenza case management capabilities in a resource-limited setting, the authors used a health system questionnaire and density-dependent, deterministic transmission model for Bali, Indonesia, determining resource gaps. The majority of health resources were focused in and around the provincial capital, Denpasar; however, gaps are found in every district for nursing staff, surgical masks, and N95 masks. A relatively low pathogenicity pandemic influenza virus would see an overall surplus for physicians, antivirals, and antimicrobials; however, a more pathogenic virus would lead to gaps in every resource except antimicrobials. Resources could be allocated more evenly across Bali. These, however, are in short supply universally and therefore redistribution would not fill resource gaps.


Assuntos
Recursos em Saúde/provisão & distribuição , Influenza Humana/epidemiologia , Influenza Humana/transmissão , Antivirais , Humanos , Indonésia/epidemiologia , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/prevenção & controle , Modelos Estatísticos , Pandemias
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