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1.
Int. j. clin. health psychol. (Internet) ; 20(3): 183-191, sept.-dic. 2020. tab, graf
Artículo en Inglés | IBECS | ID: ibc-190835

RESUMEN

BACKGROUND/OBJECTIVE: The outbreak of COVID-19 and the lack of vaccine made extraordinary actions such as social distancing necessary. While some individuals experience the restrictions on daily life as a heavy burden, others adapt to the situation and try to make the best of it. The present longitudinal study investigated the extent and predictors of the burden induced by the outbreak of COVID-19 in Germany. METHOD: Data were assessed in October 2019 using the DASS-21 and the PMH-Scale, and in March 2020 adding a six-item measure of burden and a 2-item rating of sense of control. RESULTS: In a sample of 436 participants, about 28% stayed in self-quarantine, 22 persons had relevant symptoms and one person was positively tested for COVID-19. Most participants experienced medium to high levels of burden but tried to make the best of it. Stress symptoms in 2019 predicted a higher level of burden and PMH predicted a lower level of burden in March 2020. Remarkably, depression and anxiety symptoms did not significantly predict burden. The protective effect of PMH and the negative impact of stress symptoms were mediated by perceived sense of control. CONCLUSIONS: The results emphasize the protective effect of PMH in extraordinary situations such as the current outbreak of COVID-19


ANTECEDENTES/OBJETIVO: El brote COVID-19 y la falta de vacuna hicieron necesarias acciones extraordinarias como la distancia social. Algunas personas experimentan las restricciones en la vida diaria como sobrecarga emocional y otras se adaptan a la situación, tratando de sacar lo mejor de ella. Se investigó el alcance y predictores de sobrecarga emocional inducida por el COVID-19 en Alemania. MÉTODO: Se evaluaron niveles de estrés y salud mental positiva en octubre de 2019 con DASS-21 y Escala-PMH, y en marzo de 2020, agregando medidas de sobrecarga emocional y percepción de control. RESULTADOS: En una muestra de 436 participantes, el 28% permaneció en cuarentena, 22 personas tuvieron síntomas relevantes y una dio positivo en COVID-19. La mayoría experimentaron niveles de sobrecarga emocional medio-alto, aunque trataron de sobrellevar la situación lo mejor posible. Los síntomas de estrés en octubre 2019 predijeron un nivel de sobrecarga más elevado en marzo 2020 y, contrariamente, los niveles de salud mental positiva en octubre 2019 predijeron un menor nivel de sobrecarga emocional en marzo 2020. Sorprendentemente, los síntomas de depresión y ansiedad no predijeron la sensación de sobrecarga posterior. El efecto protector de la salud mental positiva y el impacto negativo de los síntomas de estrés fueron mediados por la percepción de control. CONCLUSIONES: Se resalta el efecto protector de la salud mental positiva en situaciones extraordinarias como el brote COVID-19


Asunto(s)
Humanos , Masculino , Femenino , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/psicología , Neumonía Viral/epidemiología , Neumonía Viral/psicología , Pandemias , Cuarentena/psicología , Adaptación Psicológica , Estrés Psicológico/psicología , Depresión/psicología , Ansiedad/psicología , Estudios Longitudinales , Estudios Prospectivos , Alemania Occidental/epidemiología
2.
Rev. enferm. UERJ ; 28: e35054, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1117622

RESUMEN

Objetivo: avaliar a mobilidade do cliente com dermatose imunobolhosa antes e após aplicação do curativo com gaze vaselinada. Método: estudo quase experimental, interinstitucional, com clientes com dermatoses imunobolhosas hospitalizados em um hospital estadual e um hospital federal do Estado do Rio de Janeiro e uma instituição do Mato Grosso do Sul. Utilizou-se a lógica fuzzy para classificar a mobilidade dos sujeitos antes, 24 horas após e uma semana após aplicação do curativo. A pesquisa foi aprovada pelo Comitê de Ética em Pesquisa. Resultados: Incluídos 14 participantes, sendo nove com pênfigo vulgar, dois com pênfigo foliáceo e três com penfigóide bolhoso, entre 27 e 82 anos, predominando 11 mulheres. Após 24 horas, nenhum participante se considerou com baixa mobilidade, sete passaram a mobilidade média, e sete, alta, o que foi mantido uma semana após aplicação do curativo. Conclusão: constatou-se significativo aumento da mobilidade logo nas primeiras 24 horas após aplicação do curativo.


Objective: to assess the mobility of clients with immunobullous dermatoses, before and after applying vaseline gauze dressings. Method: in this quasi-experimental, interinstitutional study of inpatients with immunobullous dermatoses at a state hospital and a federal hospital in Rio de Janeiro State and an institution in Mato Grosso do Sul (Brazil), patient mobility before, 24 hours after, and one week after applying the dressing was classified using fuzzy logic. The study was approved by the research ethics committee. Results: 14 participants, nine with pemphigus vulgaris, two with pemphigus foliaceus, and three with bullous pemphigoid, aged between 27 and 82 years old, and predominantly (11) women. After 24 hours, none of the participants considered their mobility to be poor, seven began to be moderately mobile, and seven were highly mobile, and continued so one week after applying the dressing. Conclusion: mobility increased significant in the first 24 hours after applying the dressing.


Objetivo: evaluar la movilidad de clientes con dermatosis inmunobullosa, antes y después de la aplicación de apósitos de gasa con vaselina. Método: en este estudio cuasi-experimental, interinstitucional de pacientes hospitalizados con dermatosis inmunobullosa en un hospital estatal y un hospital federal en el estado de Río de Janeiro y una institución en Mato Grosso do Sul (Brazil), la movilidad del paciente antes, 24 horas después y una semana después la aplicación del apósito se clasificó mediante lógica difusa. El estudio fue aprobado por el comité de ética en investigación. Resultados: se incluyeron 14 participantes, nueve con pénfigo vulgar, dos con pénfigo foliáceo y tres con penfigoide ampolloso, con edades comprendidas entre 27 y 82 años, y predominantemente mujeres (n=11). Después de 24 horas, ninguno de los participantes consideró que su movilidad fuera pobre, siete comenzaron a ser moderadamente móviles y siete eran altamente móviles, y así continuaron una semana después de la aplicación del apósito. Conclusión: la movilidad aumentó significativamente en las primeras 24 horas después de la aplicación del apósitoconsideraba con baja movilidad, siete comenzaron a tener movilidad media y siete, alta, que se mantuvo una semana después de aplicar el apósito. Conclusión: hubo un aumento significativo en la movilidad en las primeras 24 horas después de aplicar el apósito.


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Vaselina/uso terapéutico , Vendajes , Enfermedades Cutáneas Vesiculoampollosas/terapia , Penfigoide Ampolloso/terapia , Pénfigo/terapia , Limitación de la Movilidad , Brasil , Lógica Difusa , Úlcera por Presión/prevención & control , Prevención Secundaria , Ensayos Clínicos Controlados no Aleatorios como Asunto , Hospitales Públicos , Pacientes Internos , Atención de Enfermería
3.
Eur. j. psychol. appl. legal context (Internet) ; 12(2): 53-60, jul.-dic. 2020. tab, graf
Artículo en Inglés | IBECS | ID: ibc-190649

RESUMEN

Intimate partner sexual violence has countless consequences for women suffering it. This research analyse the effect of the type of sexual coercion tactic and partner dependence on both the attribution of responsibility and the probability of leaving a relationship. In Study 1, six scenarios for different sexual tactics were presented (coaxing, coercion, and aggression) to 5 experts in order to select those with better evidence of content validity regarding the construct evaluated. In Study 2, the three selected scenarios were presented to 304 Spanish participants from the general population, analysing the effect of the type of tactic and dependence on attributed responsibility and the probability of leaving a relationship. Results showed that in the sexual aggression scenario, participants assigned the highest responsibility to the aggressorand showed the strongest likelihood of leaving the relationship. Further, results revealed that in the coaxing scenario, dependence had an indirect effect on the probability of leaving the relationship through a lower responsibility attributed to the aggressor. As a conclusion, this study emphasises the importance of the sexual tactic used by aggressors in individuals' perception about sexual coercion, contributing to increasing the visibility of this unacceptable action, especially in its more subtle and normalised form


La violencia sexual en las relaciones de pareja tiene innumerables consecuencias para las mujeres que la sufren. Esta investigación analiza el efecto del tipo de táctica de coerción sexual y la dependencia de la pareja en la atribución de responsabilidad y la probabilidad de dejar la relación. En el Estudio 1 se presentaron seis escenarios sobre diferentes tácticas sexuales(persuasión, coerción y agresión) a 5 expertos con la finalidad de seleccionar a aquellos que mostraran una mayor validez de contenido con respecto al constructo evaluado. En el Estudio 2, 304 participantes leyeron los tres escenarios seleccionados y se analizó el efecto del tipo de táctica y la dependencia en la responsabilidad atribuida y en la probabilidad de dejar la relación. Los resultados mostraron que los participantes responsabilizaban más al agresor y dejarían con más probabilidad la relación en la condición de agresión sexual que en la condición de coerción sexual o persuasión sexual. Además, los resultados revelan que en el escenario más sutil (persuasión) la dependencia tiene un efecto indirecto sobre probabilidad de dejar la relación a través de una menor responsabilidad atribuida al agresor. Como conclusión, esta investigación enfatiza la importancia que tiene la táctica sexual utilizada por el agresor en la percepción de la coerción sexual, contribuyendo a aumentar la visibilidad de este acto inaceptable, especialmente en su forma más sutil y normalizada


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Delitos Sexuales/psicología , Violencia de Pareja/psicología , Dependencia Psicológica , Manejo Psicológico , Factores de Riesgo
4.
Texto & contexto enferm ; 29: e20180471, Jan.-Dec. 2020. tab
Artículo en Inglés | LILACS, BDENF - Enfermería | ID: biblio-1059140

RESUMEN

ABSTRACT Objective: to analyze the knowledge of the elderly assisted by the Unified Health System (Sistema Único de Saúde, SUS) about HIV/AIDS infection in a health unit, before and after an educational intervention. Method: a quasi-experimental study analyzing the changes related to the knowledge about HIV/AIDS of 60 elderly individuals divided into two groups, who participated in an educational intervention, in an outpatient clinic of a SUS rehabilitation center in the second half of 2016. To evaluate the effectiveness of the teaching/learning process, a semi-structured questionnaire called QHIV3I was applied before and after the intervention. For data analysis, the generalized version of McNemar's chi-square test was used. Results: comparing the knowledge of the elderly before and after the educational intervention showed a higher number of correct answers, with a minimum percentage of 3.34% and a maximum of 75%. Significant statistical differences were found in one of the questions in the concept, transmission and treatment domains; and in the two vulnerability questions. Conclusion: it was found that the educational intervention contributed to the improvement of knowledge about HIV/AIDS in the elderly population. Thus, it is reasserted that the health promotion policy finds its essential foundation in health education strategies.


RESUMEN Objetivo: analizar el conocimiento de los ancianos atendidos por el Sistema Único de Salud (SUS) acerca de la infección por VIH/SIDA en una unidad de salud, tanto antes como después de una intervención educativa. Método: estudio cuasi-experimental en el que se analizaron los cambios relacionados con el conocimiento sobre VIH/SIDA de 60 ancianos subdivididos en dos grupos y que participaron de una intervención educativa en el área de atención ambulatoria de un centro especializado en rehabilitación del SUS, durante el segundo semestre de 2016. Para evaluar la eficacia del proceso de enseñanza/aprendizaje se aplicó un cuestionario semiestructurado denominado QHIV3I, antes y después de la intervención. En el análisis de los datos se utilizó la versión generalizada de la prueba de chi-cuadrado de McNemar. Resultados: en la comparación de los conocimientos de los ancianos antes y después de la intervención educativa se evidenció una mayor cantidad de respuestas correctas, con un porcentaje mínimo de 3,34% y uno máximo de 75%. Se encontraron diferencias significativas en una de las preguntas de los dominios de concepto y de transmisión y tratamiento, además de en las dos preguntas sobre vulnerabilidad. Conclusión: se constató que la intervención educativa contribuyó a mejorar los conocimientos sobre VIH/SIDA en la población de la tercera edad. Esto reafirma que la política de promoción de la salud encuentra sus fundamentos esenciales en las estrategias de educación en salud.


RESUMO Objetivo: analisar o conhecimento dos idosos atendidos pelo Sistema Único de Saúde (SUS) acerca da infecção do HIV/aids numa unidade de saúde, antes e após intervenção educativa. Método: estudo quase-experimental, em que se analisou as mudanças relativas ao conhecimento sobre HIV/aids de 60 idosos subdivididos em dois grupos, que participaram de intervenção educativa, num ambulatório de um centro especializado em reabilitação do SUS no segundo semestre de 2016. Para avaliar a eficácia do processo de ensino/aprendizagem, aplicou-se questionário semiestruturado denominado QHIV3I, antes e após a intervenção. Na análise dos dados, utilizou-se a versão generalizada do teste qui-quadrado de McNemar. Resultados: a comparação dos conhecimentos dos idosos antes e depois da intervenção educativa evidenciaram maior número de acertos, com percentual mínimo de 3,34% e máximo de 75%. Diferenças estatísticas significativas foram encontradas em uma das questões nos domínios conceito, transmissão e tratamento; e nas duas questões sobre vulnerabilidade. Conclusão: constatou-se que a intervenção educativa contribuiu para o aprimoramento de conhecimentos sobre HIV/aids na população idosa. Com isso, reafirma-se que a política de promoção da saúde encontra nas estratégias de educação em saúde seu alicerce essencial.


Asunto(s)
Humanos , Anciano , Salud del Anciano , Educación en Salud , Síndrome de Inmunodeficiencia Adquirida , VIH , Sistema Único de Salud , Salud , Transmisión de Enfermedad Infecciosa , Promoción de la Salud , Aprendizaje
5.
Rev. enferm. UERJ ; 28: e47321, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1116094

RESUMEN

Objetivo: analisar a produção científica nacional e internacional, buscando as interfaces existentes entre os princípios bioéticos e os cuidados em saúde prestados ao fim da vida às pessoas idosas. Método: revisão integrativa, cuja busca ocorreu entre outubro e novembro de 2019 nas bases de dados Medline via Pubmed, Lilacs e Scopus com os descritores: "Palliative Care", "Aged" e "Bioethics" de 2014-2019. Resultados: a partir dos artigos selecionados, emergiram as seguintes categorias: condutas terapêuticas frente aos cuidados ao fim da vida; tomada de decisão nos cuidados ao fim da vida; e desafios nos cuidados ao fim da vida. Conclusão: destaca-se a relevância dos profissionais manterem o compromisso com a pessoa idosa e sua família de forma a considerar suas subjetividades e preferências e os instrumentalizar para que os cuidados sejam pautados em princípios bioéticos, para assim proporcionar um processo de morte e de morrer com dignidade.


Objective: to examine the Brazilian and international scientific production for connections between bioethical principles and the health care provided to older adults at the end of their lives. Method: between October and November 2019 this integrative review searched the Medline (Pubmed), Lilacs, and Scopus databases using the descriptors: "Palliative Care", "Aged", and "Bioethics" for the period 2014-2019. Results: the following categories emerged from the selected articles: therapeutic conducted with regard to end-of-life care; decision making on end-of-life care; and challenges in end-of-life care. Conclusion: of particular importance is for health professionals to uphold their commitment to older adults and their families, consider their subjectivities and preferences, and empower and equip them so that care is guided by bioethical principles in order to assure a dignified process of dying and death.


Objetivo: examinar la producción científica brasileña e internacional en busca de conexiones entre los principios bioéticos y la atención médica brindada a los adultos mayores al final de sus vidas. Método: entre octubre y noviembre de 2019, esta revisión integradora buscó en las bases de datos Medline (Pubmed), Lilacs y Scopus utilizando los descriptores: "Cuidados paliativos", "Envejecido" y "Bioética" para el período 2014-2019. Resultados: las siguientes categorías surgieron de los artículos seleccionados: terapéutico realizado con respecto a la atención al final de la vida; toma de decisiones sobre la atención al final de la vida; y desafíos en la atención al final de la vida. Conclusión: es de particular importancia que los profesionales de la salud mantengan su compromiso con los adultos mayores y sus familias, consideren sus subjetividades y preferencias, y los empoderen y equipen para que la atención se guíe por principios bioéticos para asegurar un proceso digno de muerte y muerte.


Asunto(s)
Humanos , Anciano , Anciano de 80 o más Años , Actitud del Personal de Salud , Cuidados Paliativos al Final de la Vida/ética , Discusiones Bioéticas , Personeidad , Muerte , Relaciones Profesional-Familia/ética , Relaciones Profesional-Paciente/ética , Actitud Frente a la Muerte , Valor de la Vida
6.
Rev. bioét. derecho ; (50): 407-423, nov. 2020. tab, graf
Artículo en Portugués | IBECS | ID: ibc-191365

RESUMEN

O processo de consentimento informado para participação de pesquisa com seres humanos visa fornecer as informações adequadas ao indivíduo possibilitando que este tome a decisão de participar de maneira voluntária, livre de pressões externas. A possibilidade de remuneração poderia interferir na voluntariedade deste processo de consentir. O presente estudo objetivou avaliar percepção de influência da remuneração monetária por meio de simulações de pesquisa que variam em nível de risco (Bioequivalência e de Fase I) e tipo de remuneração monetária (com e sem). Participaram do estudo 80 voluntários. Os resultados sugerem que a remuneração não constituiu uma interferência na voluntariedade do processo de consentimento, visto que participantes aceitaram convite para participar da primeira pesquisa para a qual foram convidados e não se sentiram influenciados indebidamente


El proceso de consentimiento informado para la participación de sujetos humanos en investigación tiene por objeto dar la información adecuada al individuo, permitiendo que tome la decisión de participar de manera voluntaria y libre de presiones externas. La posibilidad de remuneración podría interferir en la voluntariedad de este proceso de consentir. El presente estudio evalúa la percepción de la influencia de la remuneración monetaria a través de simulaciones de investigación que varían en nivel de riesgo (Bioequivalencia y de Fase I) y tipo de remuneración monetaria (con y sin). Participaron del estudio 80 voluntarios. Los resultados sugieren que la remuneración no constituyó una interferencia en la voluntariedad del proceso de consentimiento, ya que los participantes aceptaron una invitación para participar en la primera encuesta a la que fueron invitados y no se sintieron influenciados incorrectamente


El procés de consentiment informat per a la participació de subjectes humans en recerca té per objecte donar la informació adequada a l'individu, permetent que prengui la decisió de participar de manera voluntària I lliure de pressions externes. La possibilitat de remuneració podria interferir en la voluntarietat d'aquest procés de consentir. El present estudi avalua la percepció de la influència de la remuneració monetària a través de simulacions de recerca que varien en nivell de risc (Bioequivalencia I de Fase I) I tipus de remuneració monetària (amb I sense). Van participar de l'estudi 80 voluntaris. Els resultats suggereixen que la remuneració no va constituir una interferència en la voluntarietat del procés de consentiment, ja que els participants van acceptar una invitació per a participar en la primera enquesta a la qual van ser convidats I no es van sentir influenciats incorrectament


The process of informed consent for research participation with human beings aims to provide appropriate information to individuals enabling him or her to make the decision to participate voluntarily, free of external pressures. The possibility of remuneration could interfere in the willingness to consent. The present study aims to evaluate the perception of influence of the monetary payment through research simulations that vary in the level of risk (Bioequivalence and Phase I) and type of monetary payment (with and without). Eighty volunteers participated in the study. The results suggest that remuneration did not interfere with the willingness of the consent process, as participants accepted an invitation to participate in the first research option to which they were invited to and did not feel undue influence


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , Investigación Biomédica/economía , Remuneración , Decisiones , Consentimiento Informado , Ética en Investigación , Factores Socioeconómicos
7.
Recurso de Internet en Portugués | LIS - Localizador de Información en Salud | ID: lis-47910

RESUMEN

Os sistemas de saúde nas Américas não estão respondendo adequadamente às necessidades das pessoas idosas e devem ser adaptados à luz da pandemia de COVID-19, afirmam especialistas da Organização Pan-Americana da Saúde (OPAS). Para o Dia Internacional do Idoso, celebrado no primeiro dia de outubro, o organismo internacional pede atenção integral, integrada e centrada nas pessoas e serviços de atenção primária à saúde que atendam necessidades dos idosos


Asunto(s)
Infecciones por Coronavirus , Américas/epidemiología , Anciano/estadística & datos numéricos
8.
Actas dermo-sifiliogr. (Ed. impr.) ; 111(8): 629-638, oct. 2020.
Artículo en Español | IBECS | ID: ibc-188364

RESUMEN

BACKGROUND AND OBJECTIVES: Spain is in a situation of indefinite lockdown due to the ongoing coronavirus disease 2019 (COVID-19) pandemic. One of the consequences of this lockdown is delays in medical and surgical procedures for common diseases. The aim of this study was to model the impact on survival of tumor growth caused by such delays in patients with squamous cell carcinoma (SCC) and melanoma. MATERIAL AND METHODS: Multicenter, retrospective, observational cohort study. We constructed an exponential growth model for both SCC and melanoma to estimate tumor growth between patient-reported onset and surgical excision at different time points. RESULTS: Data from 200 patients with SCC of the head and neck and 1000 patients with cutaneous melanoma were included. An exponential growth curve was calculated for each tumor type and we estimated tumor size after 1, 2, and 3 months of potential surgical delay. The proportion of patients with T3 SCC (diameter > 4 cm or thickness > 6 mm) increased from 41.5% (83 patients) in the initial study group to an estimated 58.5%, 70.5%, and 72% after 1, 2, and 3 months of delay. Disease-specific survival at 2, 5, and 10 years in patients whose surgery was delayed by 3 months decreased by 6.2%, 8.2%, and 5.2%, respectively. The proportion of patients with ultrathick melanoma (> 6 mm) increased from 6.9% in the initial study group to 21.9%, 30.2%, and 30.2% at 1, 2, and 3 months. Five-and 10-year disease-specific survival both decreased by 14.4% in patients treated after a potential delay of 3 months. CONCLUSIONS: In the absence of adequate diagnosis and treatment of SCC and melanoma in the current lockdown situation in Spain, we can expect tosee to a considerable increase in large and thick SCCs and melanomas. Efforts must be taken to encourage self-examination and facilitate access to dermatologists in order to prevent further delays


ANTECEDENTES Y OBJETIVOS: La pandemia del coronavirus COVID-19 ha provocado un confinamiento indefinido. Una posible consecuencia de esta situación es un retraso en los procedimientos asistenciales de las patologías comunes. El objetivo de este estudio es estimar el hipotético impacto en la supervivencia que tendría el aumento del tamaño tanto para los carcinomas de células escamosas (CCE) como de los melanomas. MATERIAL Y MÉTODO: Estudio observacional retrospectivo de cohortes multicéntrico. Se desarrolló un modelo de crecimiento exponencial para cada tumor basado en el tiempo de evolución que refiere el paciente. RESULTADOS: Se incluyeron un total de 200 pacientes con CCEs localizados en la cabeza y el cuello y 1000 pacientes con melanoma cutáneo. Se calculó una curva de crecimiento exponencial para cada tumor y se estimó el tamaño del tumor tras 1, 2 y 3 mes tras el diagnóstico. En la muestra, los CCE mayores de 4 cm o > 6 mm de grosor (definidos como T3) pasaron de 83 (41.5%) en el grupo de estudio real a una estimación de 58,5%, 70,5% y 72% tras 1, 2 y 3 meses de retraso quirúrgico estimado. Se estimó una disminución de la supervivencia específica de enfermedad (SEE) de un 6,2%, 8,2% y 5,2% a los 2, 5 y 10 años, respectivamente, tras tres meses de retraso. Para los melanomas, los melanomas ultragruesos (> 6 mm) pasaron del 6,9% en el grupo de estudio al 21,9%, 30,2% y 30,2% tras 1,2 y 3 meses de demora. La SEE a los 5 y 10 años del grupo de estudio descendió un 14,4% en ambos tiempos. CONCLUSIONES: En ausencia de un adecuado diagnóstico y tratamiento de los pacientes con CCE y melanoma en la actual situación de confinamiento en España, podemos llegar a asistir a un considerable aumento de los casos de CCE y melanomas gruesos y de gran tamaño. Se deben fomentar los esfuerzos para promocionar la autoexploración y facilitar el acceso a los dermatólogos para no aumentar la demora de estos pacientes. Palabras clave: melanoma, pronóstico, diagnóstico precoz, carcinoma de células escamosas cutáneo, COVID-19, confinamiento


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Neoplasias de Células Escamosas/mortalidad , Melanoma/mortalidad , Neoplasias Cutáneas/mortalidad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Betacoronavirus , Pandemias , Cuarentena , Análisis de Supervivencia , Estudios Retrospectivos , Estudios de Cohortes
9.
Comunidad (Barc., Internet) ; 22(2): 0-0, jul.-oct. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-193596

RESUMEN

La soledad y el apoyo social deficiente están reconocidos como predictores de morbimortalidad. Cuando una persona mayor vive sola y no recibe soporte familiar ni social para corregir desviaciones en su autocuidado, se produce una sobreutilización de servicios sanitarios y, posiblemente, un aumento de los ingresos hospitalarios. En 2018, el Consell de Salut del Centro de Salud (CS) República Argentina de Valencia realizó un estudio piloto de detección y abordaje de soledad no deseada en las personas del barrio en el que se estableció que un 45% de las personas que vivían solas y eran mayores de 75 años tendrían un posible diagnóstico de aislamiento social. OBJETIVOS: implementar una red comunitaria de voluntariado de acompañamiento-vigilancia en autocuidados para personas mayores con aislamiento social en el área del CS República Argentina, con el soporte del «Programa de acompañamiento en salud constante» (PASC) de la Cruz Roja, en colaboración con el centro de salud, y estudiar la relación entre soledad y salud. MÉTODOS: mediante un diseño escalado de detección y diagnóstico de aislamiento social, con la participación de técnicos de la Cruz Roja, profesionales del centro de salud y la colaboración de voluntariado de acompañamiento a personas mayores participantes. RESULTADOS: en 7 meses 1.200 personas fueron sensibilizadas de forma directa sobre la soledad y 49 voluntarios del barrio desarrollaron labores de acompañamiento y asistencia a talleres formativos y lúdicos. Los profesionales sanitarios analizaron 216 casos: 149 (69%) no se sintieron solos y 67 (31%) fueron diagnosticados de aislamiento social (código correspondiente a V64.01 según CIE-9). Participaron en el proyecto 54 personas (25%). Existe asociación entre la escala de detección de la soledad existencial (EDSOL) y la participación en el proyecto. La sensación de soledad no deseada presenta correlación positiva con problemas de movilidad, cronicidad y una tendencia de asociación con otras variables de salud (consumo elevado de fármacos, percepción negativa de calidad de vida, etc.). CONCLUSIONES: las intervenciones comunitarias promovidas desde el centro de salud sobre personas que viven solas contribuyen al abordaje del aislamiento no deseado y a su vez generan un barrio más solidario


Loneliness and poor social support are widely recognized as predictors of morbidity and mortality. When an elderly person lives alone and does not receive family or social support to correct minor deviations in basic self-care processes, this leads to overuse of health services and possibly, increased hospital admissions. In 2018, the Consell de Salut of the República Argentina Primary Health Centre in Valencia, began a pilot study to detect and tackle unwanted loneliness in people from the neighbourhood, in which it was established that 45% of people aged over 75 years old who lived alone may be diagnosed with social isolation. OBJECTIVES: To establish a community network of accompanying-surveillance volunteers in self-care for socially isolated elderly people in the area of the República Argentina Primary Care Centre with the support of the Red Cross Constant Health Accompaniment Programme. The specific objective is to study the relationship between loneliness and health. METHODS: Using a scaled design for the detection and diagnosis of social isolation, with the participation of the Red Cross technicians, professionals from the health center, and the collaboration of volunteer support for elderly participants. RESULTS: Over seven months a total of 1200 people have been directly made aware about loneliness and 49 volunteers from the neighbourhood performed accompaniment work and attended training and recreational workshops. Health professionals analyzed 216 cases, of which 149 (69%) did not feel alone and the remaining 67 (31%) were diagnosed with social isolation (code V64.01 according to ICD-9). A total of 54 (25%) agreed to take part in the project. An association was observed between the scale for detection of existential loneliness (EDSOL) and participation in the project. The feeling of unwanted loneliness correlates positively with mobility problems, chronicity and a tendency of association with other health variables such as high consumption of drugs and negative perception of quality of life. CONCLUSIONS: Community interventions promoted by the Primary Health Centre on people who live alone contribute to tackling unwanted isolation, which at the same time generates a more supportive neighbourhood


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Participación de la Comunidad/métodos , Redes Comunitarias , Anciano Frágil/psicología , Programas Voluntarios , Agencias Voluntarias , Soledad , Argentina , Calidad de Vida
10.
Rev. esp. quimioter ; 33(5): 369-378, oct. 2020. tab, graf
Artículo en Inglés | IBECS | ID: ibc-193705

RESUMEN

BACKGROUND: There are few descriptions of the clinical presentation and evolution of consecutive SARS-CoV-2 infections with a long-enough follow up. METHODS: Description of the first consecutive 100 patients with microbiologically-proven COVID-19 in a large hospital in Madrid, Spain including a minimum of two-month follow up. RESULTS: The median age of the patients (52% males) was 61.5 years (IQR=39.5-82.0) and the median BMI was 28.8 kg/m2 (IQR=24.7-33.7). Overall 72% of the patients had one or more co-morbid conditions with a median age-adjusted Charlson index of 2 (IQR=0-5.7). Five patients (5%) were immunosuppressed. The most common symptoms at the time of diagnosis were fever (80.0%), cough (53.0%) and dyspnea (23.0%). The median O2 saturation at the time of first examination was 94% (IQR=90-97). Chest X-ray on admission was compatible with pneumonia in 63% of the cases (bilateral in 42% and unilateral in 21%). Overall, 30% were managed at home and 70% were admitted to the hospital. Thirteen patients were admitted to the ICU with a median of 11 days of stay in the Unit (IQR=6.0-28.0). CALL score of our population ranged from 4 to 13. Overall, 60.0% of patients received antibiotic treatment and 66.0%, empirical antiviral treatment, mainly with lopinavir/ritonavir (65%) or hydroxychloroquine (42%). Mortality, with a minimum of 60 days of follow up, was 23%. The median age of the deceased patients was 85 years (IQR=79-93). CONCLUSIONS: We found a high mortality in the first 100 patients diagnosed with COVID-19 at our institution, associated with advanced age and the presence of serious underlying diseases


ANTECEDENTES: Existen pocas descripciones de la presentación clínica y evolución de infecciones consecutivas por SARS-CoV-2 con un seguimiento lo suficientemente largo. MÉTODOS: Descripción de los primeros 100 pacientes consecutivos con COVID-19 probada microbiológicamente en un gran hospital de Madrid, incluyendo un seguimiento mínimo de dos meses. RESULTADOS: La mediana de edad de los pacientes (52% hombres) fue de 61,5 años (RIC=39,5-82,0) y la mediana de IMC fue de 28,8 kg/m2 (RIC=24,7-33,7). El 72% de los pacientes tuvieron una o más comorbilidades con un índice de Charlson ajustado a la edad de 2 (RIC=0-5,7). Cinco pacientes (5%) estaban inmunodeprimidos. Los síntomas más comunes al momento del diagnóstico fueron fiebre (80,0%), tos (53,0%) y disnea (23,0%). La mediana de saturación de O2 en el momento del primer examen fue del 94% (RIC=90-97). La radiografía de tórax al ingreso fue compatible con neumonía en el 63% de los casos (bilateral en el 42% y unilateral en el 21%). El 30% fueron manejados en su domicilio y el 70% ingresados en el hospital. Trece pacientes ingresaron en la UCI con una mediana de 11 días de estancia en la Unidad (RIC=6,0-28,0). El score CALL de nuestra población varió de 4 a 13. En general, el 60,0% de los pacientes recibió tratamiento antibiótico y el 66,0%, tratamiento antiviral empírico, principalmente con lopinavir/ritonavir (65%) o hidroxicloroquina (42%). La mortalidad, con un mínimo de 60 días de seguimiento, fue del 23%. La mediana de edad de los pacientes fallecidos fue de 85 años (RIC=79-93). CONCLUSIONES: Encontramos una alta mortalidad en los primeros 100 pacientes diagnosticados con COVID-19 en nuestra institución, asociada con edad avanzada y presencia de enfermedades subyacentes graves


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Infecciones por Coronavirus/epidemiología , Síndrome Respiratorio Agudo Grave/epidemiología , Virus del SRAS/patogenicidad , Neumonía Viral/epidemiología , Mortalidad Hospitalaria/tendencias , España/epidemiología , Estadísticas Hospitalarias , Antivirales/uso terapéutico , Reacción en Cadena de la Polimerasa/estadística & datos numéricos , Infecciones por Coronavirus/complicaciones , Índice de Severidad de la Enfermedad
12.
Goiânia; s.n; out. 02, 2020. 1-24 p. ilus, tab, mapas, graf.(Boletim Epidemiológico Covid-19, 26).
Monografía en Portugués | Coleciona SUS, CONASS, SES-GO | ID: biblio-1121439

RESUMEN

O Boletim Epidemiológico COVID-19 objetiva documentar e divulgar informações oficiais atualizadas da situação epidemiológica no Estado de Goiás-GO, Brasil. Resume que desde os primeiros registros na China em dezembro de 2019 até o dia 26 de setembro foram confirmados 32.730.945 casos de COVID-19 no mundo. Deste total, 991.224 evoluíram a óbito. Quando comparados o número de casos e óbitos confirmados desta semana epidemiológica (SE 39) com a semana anterior, houve aumento de 6,7% nos casos e 3,8% nos óbitos. Sintetiza que, no Brasil, neste mesmo intervalo de tempo, o aumento foi 4,2% e 3,5% no número de casos e óbitos, respectivamente. No país o primeiro caso foi confirmado no dia 26 de fevereiro e até 26 de setembro foram registrados 4.717.991 casos confirmados com 141.406 óbitos. Informa que o registro dos primeiros casos suspeitos em Goiás foi a partir de 04 de fevereiro e até 26 de setembro foram notificados à Vigilância Epidemiológica 595.334 casos de COVID-19. Infere que, nesta última semana epidemiológica (SE 39) houve a confirmação de 17.551 casos novos, representando um aumento nos casos de COVID-19 de 9,5%, superior ao aumento observado no Brasil 4,2%. No Estado, 202.528 (34,0%) foram confirmados sendo 196.210 (96,9%) por critério laboratorial, 4.408 (2,2%) pelo critério clínico-epidemiológico, 589 (0,3%) por critério clínico imagem e 802 (0,4%) pelo critério clínico, 148.086 (24,9%) foram descartados e 221.461 (37,2%) continuam como suspeitos


The COVID-19 Epidemiological Bulletin aims to document and disseminate updated official information on the epidemiological situation in the State of Goiás-GO, Brazil. It summarizes that since the first registrations in China in December 2019 until the 26th of September, 32,730,945 cases of COVID-19 have been confirmed worldwide. Of this total, 991,224 died. When comparing the number of confirmed cases and deaths of this epidemiological week (SE 39) with the previous week, there was an increase of 6.7% in cases and 3.8% in deaths. It synthesizes that, in Brazil, in this same time interval, the increase was 4.2% and 3.5% in the number of cases and deaths, respectively. In the country, the first case was confirmed on February 26 and until September 26, 4,717,991 confirmed cases were recorded, with 141,406 deaths. Informs that the record of the first suspected cases in Goiás was from February 4 and until September 26, 595,334 cases of COVID-19 were notified to the Epidemiological Surveillance. It infers that, in this last epidemiological week (SE 39), 17,551 new cases were confirmed, representing an increase in the cases of COVID-19 of 9.5%, higher than the increase observed in Brazil 4.2%. In the State, 202,528 (34.0%) were confirmed, 196,210 (96.9%) by laboratory criteria, 4,408 (2.2%) by clinical-epidemiological criteria, 589 (0.3%) by clinical image criteria and 802 (0.4%) by the clinical criterion, 148,086 (24.9%) were discarded and 221,461 (37.2%) remain as suspects


Asunto(s)
Humanos , Animales , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Neumonía Viral/epidemiología , Infecciones por Coronavirus/epidemiología , Betacoronavirus , Brasil/epidemiología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Monitoreo Epidemiológico
14.
Goiânia; s.n; out. 09, 2020. ilus, tab, mapas, graf.(Boletim Epidemiológico Covid-19, 27).
Monografía en Portugués | Coleciona SUS, CONASS, SES-GO | ID: biblio-1122129

RESUMEN

Através do Boletim Epidemiológico Covid 19 n° 27, a Secretaria Estadual de Saúde do Estado de Goiás, Brasil, tem o objetivo de informar a situação epidemiológica no período de 02 de fevereiro à 03 de outubro do ano de 2020, considerando que desde os primeiros registros na China em dezembro de 2019 até o dia 03 de outubro foram confirmados 34.804.348 casos de COVID-19 no mundo. Deste total, 1.030.738 evoluíram a óbito. Quando comparados o número de casos e óbitos confirmados desta semana epidemiológica (SE 40) com a semana anterior, houve aumento de 6,3% nos casos e 4,0%nos óbitos. No Brasil, neste mesmo intervalo de tempo, o aumento foi 4,4% e 3,7% no número de casos e óbitos, respectivamente. No país o primeiro caso foi confirmado no dia 26 de fevereiro e até 03 de setembro foram registrados 4.927.235 casos confirmados com 146.675 óbitos. O registro dos primeiros casos suspeitos em Goiás foi a partir de 04 de fevereiro e até 03 de outubro foram notificados à Vigilância Epidemiológica 630.054 casos de COVID-19. Nesta última semana epidemiológica (SE 40) houve a confirmação de 13.468 casos novos, representando um aumento nos casos de COVID-19 de 6,6%, superior ao aumento observado no Brasil 4,4%. No Estado, 215.996(34,3%) foram confirmados sendo 208.780(96,7%) por critério laboratorial, 4.920(2,3%) pelo critério clínico-epidemiológico, 660(0,3%) por critério clínico-imagem e 1.144(0,5%) pelo critério clínico, 160.855(25,5%) foram descartados e 225.955(35,9%) continuam como suspeitos


Through the Epidemiological Bulletin Covid 19 n° 27, the State Department of Health of the State of Goiás, Brazil, aims to inform the epidemiological situation in the period from February 2 to October 3 of the year 2020, considering that from the first records in China in December 2019 to October 3, 34,804,348 cases of COVID-19 worldwide were confirmed. Of this total, 1,030,738 died. When comparing the number of confirmed cases and deaths of this epidemiological week (SE 40) with the previous week, there was an increase of 6.3% in cases and 4.0% in deaths. In Brazil, in this same time interval, the increase was 4.4% and 3.7% in the number of cases and deaths, respectively. In the country the first case was confirmed on February 26 and until September 3, 4,927,235 confirmed cases were recorded with 146,675 deaths. The record of the first suspected cases in Goiás was from February 4 and until October 3 were notified to the Epidemiological Surveillance 630,054 cases of COVID-19. In this last epidemiological week (SE 40) there was the confirmation of 13,468 new cases, representing an increase in cases of COVID-19 of 6.6%, higher than the increase observed in Brazil 4.4%. In the State, 215,996 (34.3%) were confirmed being 208,780 (96.7%) by laboratory criterion, 4,920 (2.3%) by clinical and epidemiological criteria, 660 (0.3%) by clinical-imaging criterion and 1,144 (0.5%) by clinical criterion, 160,855 (25.5%) were discarded and 225,955 (35.9%) continue as suspects


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Neumonía Viral/epidemiología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Pandemias , Betacoronavirus , Brasil/epidemiología , Incidencia , Infecciones por Coronavirus/mortalidad , Monitoreo Epidemiológico
15.
Goiânia; s.n; Out. 14, 2020. ilus, tab, mapas, graf.(Boletim Epidemiológico Covid-19, 28).
Monografía en Portugués | Coleciona SUS, CONASS, SES-GO | ID: biblio-1123103

RESUMEN

Esta edição do Boletim Epidemiológico COVID19 apresenta um panorama geral desde os primeiros registros na China em dezembro de 2019 até o dia 10 de outubro foram confirmados 37.109.851 casos de COVID-19 no mundo. Deste total, 1.070.355 evoluíram a óbito. Quando comparados o número de casos e óbitos confirmados desta semana epidemiológica (SE 41) com a semana anterior, houve aumento de 6,6% nos casos e 3,8% nos óbitos. No Brasil, neste mesmo intervalo de tempo, o aumento foi 3,6% e 2,7% no número de casos e óbitos, respectivamente. No país o primeiro caso foi confirmado no dia 26 de fevereiro e até 10 de outubro foram registrados 5.103.408 casos confirmados com 150.689 óbitos. Apresenta os dados referentes a situação epidemiológica COVID-19 no período de 02 de fevereiro a 10 de outubro de 2020 no Estado de Goiás, Brasil, informando que o registro dos primeiros casos suspeitos em Goiás foi a partir de 04 de fevereiro e até 10 de outubro foram notificados à Vigilância Epidemiológica 656.938 casos de COVID-19. Nesta última semana epidemiológica (SE 40) houve a confirmação de 12.721 casos novos, representando um aumento de 5,9%, superior ao aumento observado no Brasil 3,6%. No Estado, 228.717 (34,8%) foram confirmados sendo 220.473 (96,4%) por critério laboratorial, 5.565 (2,4%) pelo critério clínico-epidemiológico, 780 (0,3%) por critério clínico-imagem e 1.393 (0,6%) pelo critério clínico, 168.061 (25,6%) foram descartados e 228.443 (34,8%) continuam como suspeitos


This edition of the EPIDEMIOLOGICAL BULLETIN COVID19 presents an overview from the first records in China in December 2019 to October 10, 37,109,851 cases of COVID-19 worldwide were confirmed. Of this total, 1,070,355 died. When comparing the number of confirmed cases and deaths of this epidemiological week (SE 41) with the previous week, there was an increase of 6.6% in cases and 3.8% in deaths. In Brazil, in this same time interval, the increase was 3.6% and 2.7% in the number of cases and deaths, respectively. In the country the first case was confirmed on February 26 and until October 10, 5,103,408 confirmed cases with 150,689 deaths were recorded. It presents data regarding the epidemiological situation COVID-19 from February 2 to October 10, 2020 in the State of Goiás, Brazil, stating that the registration of the first suspected cases in Goiás was from February 4 and until October 10, 656,938 cases of COVID-19 were reported to epidemiological surveillance. In this last epidemiological week (SE 40) there was the confirmation of 12,721 new cases, representing an increase of 5.9%, higher than the increase observed in Brazil 3.6%. In the State, 228,717 (34.8%) were confirmed to be 220,473 (96.4%) by laboratory criterion, 5,565 (2.4%) by clinical and epidemiological criteria, 780 (0.3%) by clinical-imaging criterion and 1,393 (0.6%) by clinical criterion, 168,061 (25.6%) were discarded and 228,443 (34.8%) continue as suspects


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Adulto Joven , Neumonía Viral/epidemiología , Infecciones por Coronavirus/epidemiología , Pandemias , Betacoronavirus , Neumonía Viral/diagnóstico , Neumonía Viral/mortalidad , Brasil/epidemiología , Incidencia , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/mortalidad , Monitoreo Epidemiológico
16.
Spinal Cord Ser Cases ; 6(1): 92, 2020 09 30.
Artículo en Inglés | MEDLINE | ID: mdl-32999271

RESUMEN

INTRODUCTION: We observed individuals affected by spinal cord dysfunction (SCD) after coronavirus disease 2019 (COVID-19). The aim of our report is to provide our initial experience with individuals experiencing SCD after COVID-19 in a referral center in Northern Italy, from February 21 to July 15, 2020. CASE PRESENTATION: We report on three men with SCD after COVID-19. Case 1, aged 69 years, experienced T10 AIS B paraplegia upon awakening due to spinal cord ischemia from T8 to conus medullaris, besides diffuse thromboses, 27 days after the onset of COVID-19 symptoms. Case 2, aged 56 years, reported progressive cervicalgia 29 days after COVID-19 onset associated with C3 AIS C tetraplegia. Magnetic resonance imaging (MRI) revealed a C4-C6 spinal epidural abscess (SEA) requiring a C3-C4 left hemilaminectomy. Case 3, aged 48 years, reported backache together with lower limb muscle weakness on day 16 after being diagnosed with COVID-19. Exam revealed T2 AIS A paraplegia and an MRI showed a T1-T7 SEA. He underwent a T3-T4 laminectomy. Prior to SCD, all three individuals suffered from respiratory failure due to COVID-19, required mechanical ventilation, had cardiovascular risk factors, experienced lymphopenia, and received tocilizumab (TCZ). DISCUSSION: To our knowledge, this is the first report of SCD after COVID-19. Based on our experience, we did not observe a direct viral infection, but there were two different etiologies. In Case 1, the individual developed spinal cord ischemia, whereas in Cases 2 and 3 SEAs were likely related to the use of TCZ used to treat COVID-19.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/diagnóstico por imagen , Neumonía Viral/diagnóstico por imagen , Enfermedades de la Médula Espinal/diagnóstico por imagen , Médula Espinal/diagnóstico por imagen , Anciano , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/cirugía , Humanos , Laminectomía , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/cirugía , Médula Espinal/cirugía , Enfermedades de la Médula Espinal/etiología , Enfermedades de la Médula Espinal/cirugía
17.
Cardiovasc Diabetol ; 19(1): 164, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-33004045

RESUMEN

BACKGROUND: Cardiometabolic disorders may worsen Covid-19 outcomes. We investigated features and Covid-19 outcomes for patients with or without diabetes, and with or without cardiometabolic multimorbidity. METHODS: We collected and compared data retrospectively from patients hospitalized for Covid-19 with and without diabetes, and with and without cardiometabolic multimorbidity (defined as ≥ two of three risk factors of diabetes, hypertension or dyslipidaemia). Multivariate logistic regression was used to assess the risk of the primary composite outcome (any of mechanical ventilation, admission to an intensive care unit [ICU] or death) in patients with diabetes and in those with cardiometabolic multimorbidity, adjusting for confounders. RESULTS: Of 354 patients enrolled, those with diabetes (n = 81), compared with those without diabetes (n = 273), had characteristics associated with the primary composite outcome that included older age, higher prevalence of hypertension and chronic obstructive pulmonary disease (COPD), higher levels of inflammatory markers and a lower PaO2/FIO2 ratio. The risk of the primary composite outcome in the 277 patients who completed the study as of May 15th, 2020, was higher in those with diabetes (Adjusted Odds Ratio (adjOR) 2.04, 95%CI 1.12-3.73, p = 0.020), hypertension (adjOR 2.31, 95%CI: 1.37-3.92, p = 0.002) and COPD (adjOR 2.67, 95%CI 1.23-5.80, p = 0.013). Patients with cardiometabolic multimorbidity were at higher risk compared to patients with no cardiometabolic conditions (adjOR 3.19 95%CI 1.61-6.34, p = 0.001). The risk for patients with a single cardiometabolic risk factor did not differ with that for patients with no cardiometabolic risk factors (adjOR 1.66, 0.90-3.06, adjp = 0.10). CONCLUSIONS: Patients with diabetes hospitalized for Covid-19 present with high-risk features. They are at increased risk of adverse outcomes, likely because diabetes clusters with other cardiometabolic conditions.


Asunto(s)
Betacoronavirus , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/epidemiología , Diabetes Mellitus/diagnóstico , Diabetes Mellitus/epidemiología , Neumonía Viral/diagnóstico , Neumonía Viral/epidemiología , Anciano , Anciano de 80 o más Años , Enfermedades Cardiovasculares/metabolismo , Infecciones por Coronavirus/metabolismo , Diabetes Mellitus/metabolismo , Femenino , Estudios de Seguimiento , Humanos , Masculino , Enfermedades Metabólicas/diagnóstico , Enfermedades Metabólicas/epidemiología , Enfermedades Metabólicas/metabolismo , Persona de Mediana Edad , Multimorbilidad/tendencias , Pandemias , Neumonía Viral/metabolismo , Pronóstico , Estudios Retrospectivos , Factores de Riesgo
18.
Int J Med Sci ; 17(16): 2468-2476, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33029089

RESUMEN

Rationale: Coronavirus disease 2019 (COVID-19) was first announced in Wuhan, and has rapidly evolved into a pandemic. However, the risk factors associated with the severity and mortality of COVID-19 are yet to be described in detail. Methods: We retrospectively reviewed the information of 1525 cases from the Leishenshan Hospital in Wuhan. Univariate and multivariate Cox regression analyses were generated to explore the relationship between procalcitonin (PCT) level and the progression and prognosis of COVID-19. Univariate and multivariate logistic regression analyses were performed to explore the relationship between disease severity in hospitalized patients and their PCT levels. Survival curves and the cumulative hazard function for COVID-19 progression were conducted in the two groups. To further detect the relationship between the computed tomography score and survival days, curve-fitting analyses were performed. Results: Patients in the elevated PCT group had a higher incidence of severe and critical severity conditions (P < 0.001), death, and higher computed tomography (CT) scores. There was an association between elevated PCT levels and mortality in the univariate ((hazard ratio [1], 3.377; 95% confidence interval [2], 1.012-10.344; P = 0.033) and multivariate Cox regression analysis (HR, 4.933; 95% CI, 1.170-20.788; P = 0.030). Similarly, patients with elevated PCT were more likely to have critically severe disease conditions in the univariate (odds ratio [2], 7.247; 95% CI, 3.559-14.757; P < 0.001) and multivariate logistic regression analysis (OR, 10.679; 95% CI, 4.562-25.000; P < 0.001). Kaplan-Meier curves showed poorer prognosis for patients with elevated PCT (P = 0.024). The CT score 1 for patients with elevated PCT peaked at day 40 following the onset of symptoms then decreased gradually, while their total CT score was relatively stable. Conclusion: PCT level was shown as an independent risk factor of in-hospital mortality among COVID-19 patients. Compared with inpatients with normal PCT levels, inpatients with elevated PCT levels had a higher risk for overall mortality and critically severe disease. These findings may provide guidance for improving the prognosis of patients with critically severe COVID-19.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/etiología , Infecciones por Coronavirus/mortalidad , Neumonía Viral/etiología , Neumonía Viral/mortalidad , Polipéptido alfa Relacionado con Calcitonina/sangre , Anciano , Antibacterianos/uso terapéutico , Antivirales/uso terapéutico , Betacoronavirus/efectos de los fármacos , China/epidemiología , Comorbilidad , Infecciones por Coronavirus/diagnóstico por imagen , Infecciones por Coronavirus/tratamiento farmacológico , Progresión de la Enfermedad , Femenino , Hospitalización , Humanos , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/diagnóstico por imagen , Pronóstico , Estudios Retrospectivos , Tomografía Computarizada por Rayos X
19.
Biomed Res Int ; 2020: 2138387, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33029494

RESUMEN

Coronavirus disease 2019 (COVID-19) has caused considerable morbidity and mortality worldwide since December 2019. This retrospective study determined the characteristics and prognostic factors of COVID-19 patients, focusing on inpatients who died or were discharged between 30 December 2019 and 29 February 2020 at Renmin Hospital of Wuhan University. Patients' medical histories, comorbidities, symptoms, signs, laboratory findings, computed tomography (CT) findings, and clinical management were recorded. All 293 patients were divided into the nonsurviving (n = 116) and surviving (n = 177) groups. The median age was older in the nonsurviving group than in the surviving group; most patients were older than 65 years in the nonsurviving group. The incidence rates of lymphopenia, neutrophilia, and leukocytosis were significantly higher in the nonsurviving group than in the surviving group. More patients in the nonsurviving group had increased levels of nonspecific infection markers, abnormal liver and kidney function, cardiac injury, and blood coagulation abnormalities on admission. Immune and inflammatory responses were more severely disturbed in the nonsurviving group than in the surviving group. The incidence rates of complications during hospitalization were higher in the nonsurviving group than in the surviving group. Cox regression results also showed that older age, symptoms of dyspnea, comorbidities, and complications were all predictors of death. Close monitoring and timely treatment are needed for high-risk COVID-19 patients.


Asunto(s)
Infecciones por Coronavirus/etiología , Neumonía Viral/etiología , Adulto , Anciano , Anciano de 80 o más Años , Betacoronavirus , China/epidemiología , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/mortalidad , Femenino , Mortalidad Hospitalaria , Humanos , Pacientes Internos , Masculino , Persona de Mediana Edad , Pandemias , Alta del Paciente , Neumonía Viral/epidemiología , Neumonía Viral/mortalidad , Pronóstico , Estudios Retrospectivos
20.
Artículo en Inglés | MEDLINE | ID: mdl-33036351

RESUMEN

The new corona virus infection SARS-CoV2 which was later renamed COVID-19 is a pandemic affecting public health. The fear and the constraints imposed to control the pandemic may correspondingly influence leisure activities, such as birding, which is the practice of observing birds based on visual and acoustic cues. Birders are people who carry out birding observations around the globe and contribute to the massive data collection in citizen science projects. Contrasting to earlier COVID-19 studies, which have concentrated on clinical, pathological, and virological topics, this study focused on the behavioral changes of birders. A total of 4484 questionnaire survey responses from 97 countries were received. The questionnaire had an open-ended style. About 85% of respondents reported that COVID-19 has changed their birding behavior. The most significant change in birdwatchers' behavior was related to the geographic coverage of birding activities, which became more local. People focused mostly on yard birding. In total, 12% of respondents (n = 542 cases) reported having more time for birding, whereas 8% (n = 356 cases) reported having less time for birding. Social interactions decreased since respondents, especially older people, changed their birding behavior toward birding alone or with their spouse. Women reported more often than men that they changed to birding alone or with their spouse, and women also reported more often about canceled fieldtrips or society meetings. Respondents from higher developed countries reported that they spend currently more time for birding, especially for birding alone or with their spouse, and birding at local hotspots. Our study suggests that long lockdowns with strict regulations may severely impact on leisure activities. In addition, a temporal and spatial shift in birding due to the pandemic may influence data quality in citizen science projects. As nature-based recreation will be directed more toward nearby sites, environmental management resources and actions need to be directed to sites that are located near the users, e.g., in urban and suburban areas. The results can be applied with caution to other nature-based recreational activities.


Asunto(s)
Ciencia Ciudadana , Infecciones por Coronavirus/psicología , Coronavirus , Actividades Recreativas , Neumonía Viral/psicología , Cuarentena/psicología , Factores de Edad , Anciano , Anciano de 80 o más Años , Animales , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Femenino , Humanos , Masculino , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Salud Pública , Factores Sexuales , Conducta Social , Encuestas y Cuestionarios
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