ABSTRACT
El objetivo de este estudio fue indagar sobre experiencias y percepciones del personal de salud (PDS) de la Argentina en la implementación de protocolos para su protección durante la pandemia por COVID-19. Se realizó una encuesta al PDS a nivel nacional, relevando datos sociodemográficos, de protocolos, recursos y aspectos psicosociales. Se analizaron 2010 encuestas. El 76,4% fueron mujeres, 43 años de edad media, 35% médicos/as y 72,7% del subsistema público. El 37,2% aumentó su carga horaria y el 22,5% presentaba algún factor de riesgo, de quienes 20,4% tuvo licencia o reasignación de tareas. Se establecieron protocolos sobre uso de equipos de protección personal (EPP) en 91% de las instituciones y otras temáticas en menor medida. La claridad de los mismos fue bien valorada y hubo entrenamiento en el 60,8% de los casos. La conformidad con la disponibilidad y calidad del EPP fue variable, con mejor valoración en el subsector privado. El 60,4% tuvo necesidad de obtener EPP por medios propios. El 48,4% de los encuestados siguió los protocolos de uso de EPP, variando según grupos de riesgo. El indicador global de valoración institucional fue 6,45/10 (IC 95% 6,38-6,53). El 87,2% del PDS dijo haber sentido angustia y esto se relacionó con peor comunicación con superiores y peor valoración institucional. De este estudio surgen dificultades en la implementación de los nuevos cuidados, y la necesidad de intensificar esfuerzos en recursos y organización institucional para mejorar las condiciones de trabajo.
During the COVID-19 pandemic, health personnel (HP) faced changes in their working conditions due to exposure to the virus and increased demand for attention. This study inquires on the experiences and perceptions of HP in Argentina about the implementation of protocols for their protection. A survey including information on sociodemographic characteristics, protocols, resources and psychological aspects was performed for HP all over the country. Two thousand and ten surveys were analyzed: 76.4% female, mean age 43 years old, 35% physician, 72.7% public institutions. Hours of work increased for 37.2%, 22.5% had at least one risk factor, of which 20.4% had leave or re-assigned tasks. Protocols about use of personal protective equipment (PPE) were established by 91% of institutions and less frequently about other topics. Clarity of protocols was well evaluated, and in 60.8% of cases trainament was performed. Approval about access and quality of PPE was variable, with better performance on private institutions. 60.4% of the HP had to obtain PPE by their own means. 48.4% of the participants followed protocols on PPE, being this variable according to groups of risk. The global index for institutional valuation was 6.45/10 (CI 95%, 6.38-6.53). HCP expressed fear or anxiety in 87.2% of the cases, and this was related to worse communication with superiors and worse institutional valuation. This study raises difficulties on the implementation of new protocols and the need to reinforce efforts on resources and institutional organization, to improve working conditions for HP
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Attitude of Health Personnel , Health Knowledge, Attitudes, Practice , Personal Protective Equipment , COVID-19/prevention & control , Perception , Argentina , Cross-Sectional Studies , Surveys and Questionnaires , COVID-19/psychologyABSTRACT
Abstract Chagas disease is a chronic parasitological disease, which could cause cardiac manifestations in approximately one-third of affected individuals. Benznidazole and nifurtimox are used to treat this parasitological infection caused by Trypanosoma cruzi. Conventionally, the criterion for cure is consistently negative serological tests after treatment. We report a case of a patient who was treated when she was 13 years old and achieved T. cruzi negative seroconversion but developed Chagas disease cardiomyopathy as an adult.
Subject(s)
Humans , Female , Chagas Cardiomyopathy/diagnosis , Recurrence , Trypanocidal Agents/therapeutic use , Chagas Disease/drug therapy , Disease Progression , Middle Aged , Nitroimidazoles/therapeutic useABSTRACT
Pharmacological treatment of Chagas disease with benznidazole (BNZ) is effective in children in all stages, but it is controversial in chronically infected adults. We report the pharmacokinetics and pharmacodynamics in six adult patients with Chagas disease treated with the new BNZ formulation (ABARAX®) in doses between 2.5-5.5 mg/Kg/day. All but one patient had plasmatic BNZ concentrations within the expected range. All patients finalised treatment with nondetectable Trypanosoma cruziquantitative polymerase chain reaction, which remained nondetectable at the six month follow-up. Our data suggests parasitological responses with the new BNZ and supports the hypothesis that treatment protocols with lower BNZ doses may be effective.