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1.
Goiânia; SES-GO; 01 março 2021. 1-50 p. ilus, tab.
No convencional en Portugués | LILACS, Coleciona SUS, CONASS, SES-GO | ID: biblio-1096093

RESUMEN

O surto da doença respiratória causada pelo novo coronavírus (SARS-CoV-2) aconteceu na cidade de Wuhan, capital da província de Hubei, na China, em dezembro de 2019, a qual disseminou-se de forma acelerada e, logo, atingiu mais de uma centena de países dos cinco continentes. Em 12 de março de 2020, a situação foi caracterizada como pandemia pela Organização Mundial de Saúde (OMS, 2020). Em razão da disseminação o do Coronavírus pelo mundo, o Ministério da Saúde declarou Emergência de Saúde Pública de Importância Nacional (ESPIN) em decorrência da infecção pelo novo coronavírus (COVID-19) e estabeleceu o Centro de Operações de Emergência em Saúde Pública (COE-COVID-19) como mecanismo de gestão coordenada da resposta à ESPIN no país (BRASIL, 2020a). Seguindo a linha mundial, o Ministério da Saúde elaborou e publicou "Plano de Contingência Nacional para Infecção Humana pelo Novo Coronavírus COVID-19" para organizar a detecção, monitoramento e resposta dos serviços de saúde à doença (BRASIL, 2020b). O Estado de Goiás instituiu o Centro de Operações Estratégicas de Saúde Pública (COE) em 18 de fevereiro de 2020 (GOIÁS, 2020a). E, seguindo as orientações nacionais, propõe o presente PLANO ESTADUAL DE CONTINGÊNCIA PARA O ENFRENTAMENTO DA DOENÇA PELO CORONAVÍRUS (COVID-19), a fim de organizar e fortalecer as políticas públicas de saúde, visto que, para que atinjam eficácia e eficiência, é necessário atuação conjunta e ordenada dos entes federados, bem como dos setores públicos e privados.


The outbreak of respiratory disease caused by the new coronavirus (SARS-CoV-2) occurred in Wuhan city, capital of Hubei province, China, in December 2019, which spread rapidly and thus reached more than a hundred countries on five continents. On March 12, 2020, the situation was characterized as a pandemic by the World Health Organization (WHO, 2020). Due to the spread of Coronavirus around the world, the Ministry of Health declared a Public Health Emergency of National Importance (ESPIN) due to infection by the new coronavirus (COVID-19) and established the Center for Emergency Operations in Public Health (COE-COVID-19) as a mechanism for coordinated management of the response to ESPIN in the country (BRASIL, 2020a). Following the global line, the Ministry of Health elaborated and published "National Contingency Plan for Human Infection by the New Coronavirus COVID-19" to organize the detection, monitoring and response of health services to the disease (BRASIL, 2020b). The State of Goiás established the Center for Strategic Operations of Public Health (COE) on February 18, 2020 (GOIÁS, 2020a). And, following the national guidelines, it proposes this State CONTINGENCY PLAN FOR COPING WITH CORONAVIRUS DISEASE (COVID-19), in order to organize and strengthen public health policies, since, in order to achieve effectiveness and efficiency, joint and orderly action of federal entities, as well as public and private sectors, is necessary.


Asunto(s)
Humanos , Masculino , Femenino , Embarazo , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Salud Pública , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/transmisión , Pandemias
2.
Am J Orthod Dentofacial Orthop ; 159(3): 305-311, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33641814

RESUMEN

INTRODUCTION: The early diagnosis and interception of potential maxillary canine impaction is the most desirable approach for correcting their path of eruption. However, there is still a lack of evidence regarding the effect of rapid maxillary expansion (RME) on labially impacted canines. This study aimed to investigate the age-related effect of RME on labially impacted maxillary canines in order to reduce the risk of their impaction in the mixed dentition and to examine the proper timing of interceptive treatment. METHODS: All patients aged 7-10 years were treated with an RME appliance using the same protocol. The distance to the occlusal plane, axis to the midline, and distribution in different sectors-depending on the patients' age-were evaluated for maxillary canines before and after treatment on panoramic radiographs in order to detect changes in the position of the impacted canines. These geometric measurements in the impacted canines were also validated by observing the nontreated canines at each age. RESULTS: Significant differences existed between the impacted canines and the erupted canines in all 3 categories in all age groups. RME treatment modulated the position of the impacted canines in all age groups. Interestingly, a statistically significant difference before and after RME in all categories was detected in patients aged <8 years. A discriminant analysis also showed a positive association of RME treatment with the risk of labially impacted canines. The standardized regression coefficients showed that the angulation of the maxillary canine was the most important predictor for impaction. CONCLUSIONS: Our findings indicate that RME treatment in the early mixed dentition was effective for managing labially impacted maxillary canines. An age of 7-8 years with early mixed dentition might be the most appropriate timing for therapeutic intervention on the basis of RME treatment for buccal canine impaction.


Asunto(s)
Técnica de Expansión Palatina , Diente Impactado , Estudios de Casos y Controles , Niño , Diente Canino/diagnóstico por imagen , Humanos , Maxilar/diagnóstico por imagen , Diente Impactado/diagnóstico por imagen , Diente Impactado/terapia
3.
Sheng Wu Gong Cheng Xue Bao ; 37(2): 513-529, 2021 Feb 25.
Artículo en Chino | MEDLINE | ID: mdl-33645152

RESUMEN

Bispecific antibody (BsAb) has two different antigen-binding sites, divided into the "IgG-like" format and the "non-IgG-like" format. Different formats have different characteristics and applications. BsAb has higher sensitivity and specificity than conventional antibodies, with special functions such as recruitment of immune cells and blocking of dual signaling pathways, playing an important role in immune-diagnosis and therapy. With the deterioration of the global environment and the irregular living habits of people, the incidence of tumor is becoming higher and higher. Tumor becomes the most serious fatal disease threatening human health after cardiovascular disease. There are 12 million estimated new tumor cases each year worldwide. The major clinical treatments of tumor are surgical resection, chemoradiotherapy, target therapy. Tumor immunotherapy is a novel approach for tumor treatment in recent years, and activates human immune system to control and kill tumor cells. Although the traditional monoclonal antibodies have already acquired some therapeutic effects in tumor targeted therapy and immunotherapy, they induce drug resistance resulted from the heterogeneity and plasticity of tumors. Binding to two target antigens at the same time, BsAb has been used in the clinical treatment of tumors and obtained promising outcomes. This review elaborates the research progress and applications of bispecific antibody in clinical tumor therapy.


Asunto(s)
Anticuerpos Biespecíficos , Neoplasias , Anticuerpos Biespecíficos/uso terapéutico , Anticuerpos Monoclonales/uso terapéutico , Humanos , Inmunoterapia , Neoplasias/terapia
4.
Intern Med J ; 51(2): 284-287, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33631857

RESUMEN

The COVID-19 pandemic has demanded a rapid adaptation in healthcare provision, including patients with inflammatory bowel disease (IBD). This viewpoint discusses some of the unique challenges in managing comorbid IBD and COVID-10 experienced by our team at The Royal Melbourne Hospital, which was at the epicentre of the COVID-19 'second-wave' surge in Melbourne.


Asunto(s)
/complicaciones , Prestación de Atención de Salud , Enfermedades Inflamatorias del Intestino/complicaciones , Enfermedades Inflamatorias del Intestino/terapia , Australia , Humanos , Pandemias
5.
Science ; 371(6532): 882-884, 2021 02 26.
Artículo en Inglés | MEDLINE | ID: mdl-33632831
6.
Acta Gastroenterol Belg ; 84(1): 3-8, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33639687

RESUMEN

Post-endoscopic hemostasis treatment is not adequately addressed in high-risk patients on regular hemodialysis (HD) with emergency peptic ulcer bleeding. This study aimed to compare post-endoscopic high- versus low-dose proton pump inhibitors (PPIs) for peptic ulcer bleeding in patients undergoing regular HD. This prospective study comprised 200 patients on regular hemodialysis having emergency peptic ulcer bleeding confirmed at endoscopy and managed with endoscopic hemostasis. Half of the patients received high-dose intensive regimen and the other half received the standard regimen. Patients who were suspected to have recurrent bleeding underwent a second endoscopy for bleeding control. The primary outcome measure was rate of recurrent bleeding during period of hospitalization that was detected through second endoscopy. Rebleeding occurred in 32 patients ; 15 in the High-Dose Cohort and 17 in the Low-Dose Control (p = 0.700). No significant differences between the two dose cohorts regarding the time of rebleeding (p = 0.243), endoscopic hemostasis mode (p = 1.000), and need for surgery (p = 0.306). The highdose regimen Inhospital mortality in high-dose group was 9.0% compared to 8.0% in the low-dose group (p = 0.800). Apart from the pre-hemostatic Forrest classification of ulcers, there were no significant differences between patients with re-bleeding ulcers (n=32) and those with non-rebleeding (n=168). Rebleeding was more common in class Ia, i.e. spurting bleeders (p < 0.001). Endoscopic hemostasis followed by the standard low-dose PPI regimen of 40 mg daily IV boluses is safe and effective option for bleeding peptic ulcers in the high-risk patients under regular hemodialysis.


Asunto(s)
Hemostasis Endoscópica , Úlcera Péptica , Humanos , Úlcera Péptica/complicaciones , Úlcera Péptica Hemorrágica/terapia , Estudios Prospectivos , Inhibidores de la Bomba de Protones , Recurrencia , Diálisis Renal
7.
Acta Gastroenterol Belg ; 84(1): 87-90, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33639698

RESUMEN

Hepatic encephalopathy (HE) is a leading cause of hospitalization and morbimortality in advanced cirrhosis with limited therapeutic options available. Given the paramount role of gut microbiota in HE, and the efficacy of fecal microbiota transplantation (FMT) in other diseases, this review intends to summarize the evidence supporting the safety, efficacy and future perspectives of FMT in HE. Current evidence, despite being scarce, points towards FMT being a safe, effective and tolerable procedure in HE. Some unanswered questions remain about the optimal dose, the administration route, the long term effects and the selection of the optimal donor. Future trials, some of which are already underway, will provide us additional evidence and hopefully the necessary answers.


Asunto(s)
Microbioma Gastrointestinal , Encefalopatía Hepática , Trasplante de Microbiota Fecal , Heces , Encefalopatía Hepática/terapia , Humanos , Cirrosis Hepática
8.
Acta Gastroenterol Belg ; 84(1): 95-99, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33639700

RESUMEN

Liver disease, cirrhosis and portal hypertension can be complicated by pulmonary vascular disease, which may affect prognosis and influence liver transplantation (LT) candidacy. Pulmonary vascular complications comprise hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH). Although these two conditions develop on a same background and share a common trigger, pulmonary responses are distinct and occur at different anatomical sites of the pulmonary circulation. HPS affects 10-30% of patients referred for LT, and is characterized by gas exchange abnormalities due to pulmonary vasodilation and right-to-left shunting. POPH occurs in 5%, and is defined by pulmonary arterial hypertension due to increased pulmonary vascular resistance, which leads to hemodynamic failure. Even though HPS and POPH may have a substantial negative impact on survival, both entities are clinically underrecognized and frequently misdiagnosed. Without intervention, the 5-year survival rate is 23% in HPS and 14% in POPH. Their presence should be actively sought by organized screening in patients presenting with dyspnea and in all patients on the waitlist for LT, also because clinical symptoms are commonly non-specific or even absent. LT may lead to resolution, however, advanced stages of either HPS or POPH may jeopardize safe and successful LT. This implicates the need of proper identification of HPS and POPH cases, as well as the need to be able to successfully 'bridge' patients to LT by medical intervention. A review article on this topic has been published in this journal in 2007 (1). This updated review focuses on recent advances in the diagnosis and management of these 2 liver-induced pulmonary vascular disorders and incorporates results from our recent work.


Asunto(s)
Síndrome Hepatopulmonar , Hipertensión Portal , Hipertensión Pulmonar , Hipertensión Arterial Pulmonar , Síndrome Hepatopulmonar/diagnóstico , Síndrome Hepatopulmonar/terapia , Humanos , Hipertensión Portal/complicaciones , Hipertensión Portal/diagnóstico , Hipertensión Portal/terapia , Hipertensión Pulmonar/diagnóstico , Hipertensión Pulmonar/etiología , Hipertensión Pulmonar/terapia , Cirrosis Hepática
9.
Acta Gastroenterol Belg ; 84(1): 101-120, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33639701

RESUMEN

Introduction: Hemorrhoidal disease is a common problem that arises when hemorrhoidal structures become engorged and/or prolapse through the anal canal. Both conservative and invasive treatment options are diverse and guidance to their implementation is lacking. Methods: A Delphi consensus process was used to review current literature and draft relevant statements. These were reconciliated until sufficient agreement was reached. The grade of evidence was determined. These guidelines were based on the published literature up to June 2020. Results: Hemorrhoids are normal structures within the anorectal region. When they become engorged or slide down the anal canal, symptoms can arise. Every treatment for symptomatic hemorrhoids should be tailored to patient profile and expectations. For low-grade hemorrhoids, conservative treatment should consist of fiber supplements and can include a short course of venotropics. Instrumental treatment can be added case by case : infrared coagulation or rubber band ligation when prolapse is more prominent. For prolapsing hemorrhoids, surgery can be indicated for refractory cases. Conventional hemorrhoidectomy is the most efficacious intervention for all grades of hemorrhoids and is the only choice for non-reducible prolapsing hemorrhoids. Conclusions: The current guidelines for the management of hemorrhoidal disease include recommendations for the clinical evaluation of hemorrhoidal disorders, and their conservative, instrumental and surgical management.


Asunto(s)
Hemorreoidectomía , Hemorroides , Bélgica , Hemorroides/diagnóstico , Hemorroides/terapia , Humanos , Ligadura , Resultado del Tratamiento
10.
BMC Med Inform Decis Mak ; 21(1): 34, 2021 02 01.
Artículo en Inglés | MEDLINE | ID: mdl-33522934

RESUMEN

BACKGROUND AND OBJECTIVES: Internet-based technologies play an increasingly important role in the management and outcome of patients with chronic kidney disease (CKD). The healthcare system is currently flooded with digital innovations and internet-based technologies as a consequence of the coronavirus disease 2019 (COVID-19) pandemic. However, information about the attitude of German CKD-patients with access to online tools towards the use of remote, internet-based interactions such as video conferencing, email, electronic medical records and apps in general and for health issues in particular, are missing. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: To address the use, habits and willingness of CKD patients in handling internet-based technologies we conducted a nationwide cross-sectional questionnaire survey in adults with CKD. RESULTS: We used 380 questionnaires from adult CKD patients (47.6% on dialysis, 43.7% transplanted and 8.7% CKD before renal replacement therapy) for analysis. Of these 18.9% denied using the internet at all (nonusers). Nonusers were significantly older (74.4 years, SD 11.4) than users (54.5 years, SD 14.5, p < 0.001), had a lower educational level than users (≥ 12 years: 6.9% versus 47.1%, p < 0.001) and were more often on dialysis. Within the group of internet users only a minority (2.6%) was using video conferencing with their physician, only 11.7% stated that they were using email to report symptoms and 26.6% were using the internet to schedule appointments. Slightly more than one-third of internet users (35.1%) are concerned that their personal medical data are not safe when submitted via the internet. CONCLUSIONS: Within our group of German CKD-patients we found that almost one out of five patients, especially older patients and patients with a lower educational level, did not use the internet at all. The majority of internet users reported in our survey that they have not used internet-based technologies within a medical context so far, but are willing to consider it. Therefore, it seems to be important to introduce and teach motivated CKD-patients the use and benefits of simple and safe internet-based health care technologies.


Asunto(s)
Prioridad del Paciente , Insuficiencia Renal Crónica , Telemedicina , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Alemania/epidemiología , Encuestas de Atención de la Salud , Humanos , Masculino , Persona de Mediana Edad , Prioridad del Paciente/estadística & datos numéricos , Insuficiencia Renal Crónica/terapia , Telemedicina/estadística & datos numéricos , Adulto Joven
13.
Medicine (Baltimore) ; 100(4): e24447, 2021 Jan 29.
Artículo en Inglés | MEDLINE | ID: mdl-33530251

RESUMEN

BACKGROUND: The present study aimed to systematically analyze the effects of mind-body exercise on PTSD symptom, depression and anxiety among patients with post-traumatic stress disorder (PTSD) and to provide a scientific evidence-based exercise prescription. Meanwhile, it will also help reduce the global mental health burden of COVID-19. METHODS: Both Chinese and English databases (PubMed, Web of Science, the Cochrane Library, EMBASE, VIP Database for Chinese Technical Periodicals, China National Knowledge Infrastructure, and Wanfang) were used as sources of data to search for randomized controlled trials (RCTs) published between January 1980 to September 2020 relating to the effects of mind-body exercise on PTSD symptom, depression and anxiety in PTSD patients. CONCLUSION: This systematic review and meta-analysis will provide stronger evidence on the effectiveness and safety of mind-body exercise for PTSD symptoms in PTSD patients. SYSTEMATIC REVIEW REGISTRATION: INPLASY2020120072.


Asunto(s)
Trastornos de Ansiedad/terapia , Depresión/terapia , Terapias Mente-Cuerpo , Proyectos de Investigación , Trastornos por Estrés Postraumático/terapia , Humanos , Metaanálisis como Asunto , Pandemias , Revisiones Sistemáticas como Asunto
14.
Artículo en Inglés | MEDLINE | ID: mdl-33530624

RESUMEN

Asthma is the most frequent chronic condition in childhood and a current concern exists about asthma in the pediatric population and its risk for severe SARS-CoV-2 infection. Although all ages can be affected, SARS-CoV-2 infection has lower clinical impact on children and adolescents than on adults. Fever, cough and shortness of breath are the most common symptoms and signs in children; wheezing has not been frequently reported. Published studies suggest that children with asthma do not appear to be disproportionately more affected by COVID-19. This hypothesis raises two issues: is asthma (and/or atopy) an independent protective factor for COVID-19? If yes, why? Explanations for this could include the lower IFN-α production, protective role of eosinophils in the airway, and antiviral and immunomodulatory proprieties of inhaled steroids. Additionally, recent evidence supports that allergic sensitization is inversely related to ACE2 expression. Obesity is a known risk factor for COVID-19 in adults. However, in the childhood asthma-obesity phenotype, the classic atopic Th2 pattern seems to predominate, which could hypothetically be a protective factor for severe SARS-CoV-2 infection in children with both conditions. Finally, the return to school activities raises concerns, as asymptomatic children could act as vectors for the spread of the disease. Although this is still a controversial topic, the identification and management of asymptomatic children is an important approach during the SARS-CoV-2 epidemic. Focus on asthma control, risk stratification, and medication adherence will be essential to allow children with asthma to return safely to school.


Asunto(s)
Asma , Asma/epidemiología , Asma/terapia , Niño , Humanos , Factores de Riesgo
15.
J Med Case Rep ; 15(1): 57, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33531061

RESUMEN

BACKGROUND: Maldives reported its first Coronavirus disease 2019 (COVID-19) case on March 7th, 2020. Since then more than 9400 positive cases and 33 deaths have been reported. Recently studies have shown that COVID-19 patients with diabetes had a poor prognosis and a higher mortality rate when compared to the non-diabetic patients. Poorly controlled diabetic patients had a higher incidence of complications like diabetic ketoacidosis (DKA) and hyperosmolar hyperglycemic state (HHS) which might have been precipitated by COVID-19. DKA and HHS are potentially lethal but preventable conditions. During this pandemic, although cases of uncontrolled diabetes are frequently reported, there is scarcity in reporting of cases with diabetic emergencies. CASE PRESENTATION: Case 1 was a 53-year old Asian male, admitted on Day 10th of illness with DKA with acute kidney injury, and Moderate COVID-19. Case 2 was a 72-year old Asian male, admitted with mild COVID-19 who developed HHS with acute kidney injury on day 9 of illness. Both patients were managed conservatively in intensive care unit, with intravenous fluids and insulin. CONCLUSION: Clinicians should focus on close monitoring of diabetic patients with COVID-19, to prevent diabetic emergencies like DKA and HHS. It is important to aggressively manage these conditions for a favorable outcome.


Asunto(s)
/complicaciones , Cetoacidosis Diabética/terapia , Coma Hiperglucémico Hiperosmolar no Cetósico/terapia , Anciano , Tratamiento Conservador , Urgencias Médicas , Humanos , Islas del Oceano Índico/epidemiología , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Pronóstico
16.
Hinyokika Kiyo ; 67(1): 1-6, 2021 Jan.
Artículo en Japonés | MEDLINE | ID: mdl-33535289

RESUMEN

Robot-assisted laparoscopic radical prostatectomy (RARP) is becoming the standard treatment procedure for localized prostate cancer. The main complications associated with RARP include urinary incontinence and sexual dysfunction. In addition, acute urinary retention (AUR) after urethral catheter removal is sometimes seen. Early catheter removal is a risk factor for AUR, and administration of alphablockers before catheter removal reduces the occurrence of AUR. However, the ideal management of AUR after RARP is not known. Here we report the clinical course and treatment after AUR. We performed 279 RARPs at our institution, and AUR developed in 11 cases. In all cases, urination status was improved after placement of a urinary catheter or intermittent catheterization. Later, urethral stricture was seen in 2 out of 11 cases. Ourstudy suggests that when AUR is observed afterRARP, catheterur ination should be initially performed. If urinary retention recurs, a urinary catheter should be placed with administration of alpha-blockers. The catheter is removed after about 3 days, and administration of analgesics is effective for reducing the pain on urination. If urination status is not improved, evaluation of the urethral stricture should be considered.


Asunto(s)
Laparoscopía , Neoplasias de la Próstata , Robótica , Retención Urinaria , Humanos , Masculino , Recurrencia Local de Neoplasia , Prostatectomía/efectos adversos , Neoplasias de la Próstata/cirugía , Cateterismo Urinario/efectos adversos , Retención Urinaria/etiología , Retención Urinaria/terapia
17.
Arq Bras Cardiol ; 116(1): 129-139, 2021 01.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33566977

RESUMEN

Atrial fibrillation is the most common sustained arrhythmia in clinical practice, with a preference for older age groups. Considering population ageing, the projections for the next decades are alarming. In addition to its epidemiological importance, atrial fibrillation is evidenced by its clinical repercussions, including thromboembolic phenomena, hospitalizations, and a higher mortality rate. Its pathophysiological mechanism is complex and involves an association of hemodynamic, structural, electrophysiological, and autonomic factors. Since the 1990s, the Framingham study of multivariate analyses has demonstrated that hypertension, diabetes, heart failure, and valvular disease are independent predictors of this rhythm abnormality along with age. However, various other risk factors have been recently implicated in an increase of atrial fibrillation cases, such as sedentary behavior, obesity, sleep disorders, tobacco use, and excessive alcohol use. Moreover, changes in quality of life indicate a reduction in atrial fibrillation recurrence, thus representing a new strategy for excellence in the treatment of this cardiac arrhythmia. Therapeutic management involves a broad knowledge of the patient's health state and habits, comprehending 4 main pillars: lifestyle changes and rigorous treatment of risk factors; prevention of thromboembolic events; rate control; and rhythm control. Due to the dimension of factors involved in the care of patients with atrial fibrillation, integrated actions performed by interprofessional teams are associated with the best clinical results.


Asunto(s)
Fibrilación Atrial , Insuficiencia Cardíaca , Tromboembolia , Anciano , Antiarrítmicos/uso terapéutico , Fibrilación Atrial/tratamiento farmacológico , Fibrilación Atrial/terapia , Insuficiencia Cardíaca/tratamiento farmacológico , Humanos , Calidad de Vida , Factores de Riesgo
19.
BMC Psychiatry ; 21(1): 91, 2021 02 10.
Artículo en Inglés | MEDLINE | ID: mdl-33568141

RESUMEN

BACKGROUND: Prior to the COVID-19 pandemic, physicians experienced unprecedented levels of burnout. The uncertainty of the ongoing COVID-19 pandemic along with increased workload and difficult medical triage decisions may lead to a further decline in physician psychological health. METHODS: We searched Medline, EMBASE, and PsycINFO for primary research from database inception (Medline [1946], EMBASE [1974], PsycINFO [1806]) to November 17, 2020. Titles and abstracts were screened by one of three reviewers and full-text article screening and data abstraction were conducted independently, and in duplicate, by three reviewers. RESULTS: From 6223 unique citations, 480 articles were reviewed in full-text, with 193 studies (of 90,499 physicians) included in the final review. Studies reported on physician psychological symptoms and management during seven infectious disease outbreaks (severe acute respiratory syndrome [SARS], three strains of Influenza A virus [H1N1, H5N1, H7N9], Ebola, Middle East respiratory syndrome [MERS], and COVID-19) in 57 countries. Psychological symptoms of anxiety (14.3-92.3%), stress (11.9-93.7%), depression (17-80.5%), post-traumatic stress disorder (13.2-75.2%) and burnout (14.7-76%) were commonly reported among physicians, regardless of infectious disease outbreak or country. Younger, female (vs. male), single (vs. married), early career physicians, and those providing direct care to infected patients were associated with worse psychological symptoms. INTERPRETATION: Physicians should be aware that psychological symptoms of anxiety, depression, fear and distress are common, manifest differently and self-management strategies to improve psychological well-being exist. Health systems should implement short and long-term psychological supports for physicians caring for patients with COVID-19.


Asunto(s)
Subtipo H1N1 del Virus de la Influenza A , Subtipo H5N1 del Virus de la Influenza A , Subtipo H7N9 del Virus de la Influenza A , Médicos , Depresión/epidemiología , Depresión/terapia , Brotes de Enfermedades , Femenino , Humanos , Masculino , Pandemias , Estrés Psicológico
20.
Artículo en Ruso | MEDLINE | ID: mdl-33580758

RESUMEN

OBJECTIVE: To evaluate social, demographic and clinical characteristics of women with schizophrenia and HIV. MATERIAL AND METHODS: Medical histories of patients who were in inpatient treatment during 2017 were retrospectively studied. A total of 174 medical histories were analyzed, but the final analysis included 40 HIV-infected patients (main groups) and 48 patients without HIV infection (comparison group). These groups included patients with a diagnosis of schizophrenia or acute polymorphic psychotic disorder. All patients with HIV infection were examined by a specialist and an immunological analysis was performed. Correlation analysis was performed between quantitative clinical indicators (duration of illness, number of hospitalizations, the number and duration of remissions, etc.) and immunological parameters. RESULTS AND CONCLUSION: Patients with schizophrenia and HIV infection are more often hospitalized and stay in the hospital longer than patients with schizophrenia without HIV infection, which may in part be determined by the social problems of this cohort of patients. There is a relationship between individual indicators of the immune status of the patients, the duration and some features of the course of mental illness. Regular treatment of HIV infection correlates with a lower frequency of hospitalizations in a psychiatric hospital due to an exacerbation of the mental state.


Asunto(s)
Infecciones por VIH , Trastornos Psicóticos , Esquizofrenia , Demografía , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/epidemiología , Humanos , Estudios Retrospectivos , Esquizofrenia/diagnóstico , Esquizofrenia/epidemiología , Esquizofrenia/terapia
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