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2.
BMC Infect Dis ; 20(1): 734, 2020 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-33028245

RESUMEN

BACKGROUND: HIV continues to be the main determinant morbidity with high mortality rates in Sub-Saharan Africa, with a high number of patients being late presenters with advanced HIV. Clinical management of advanced HIV patients is thus complex and requires strict adherence to updated, empirical and simplified guidelines. The current study investigated the impact of the implementation of a new clinical guideline on the management of advanced HIV in Kinshasa, Democratic Republic of Congo (DRC). METHODS: A retrospective analysis of routine clinical data of advanced HIV patients was conducted for the periods; February 2016 to March 2017, before implementation of new guidelines, and November 2017 to July 2018, after the implementation of new guidelines. Eligible patients were patients with CD4 < 200 cell/µl and presenting with at least 1 of 4 opportunistic infections. Patient files were reviewed by a medical doctor and a committee of 3 other doctors for congruence. Statistical significance was set at 0.05%. RESULTS: Two hundred four and Two hundred thirty-one patients were eligible for inclusion before and after the implementation of new guidelines respectively. Sex and age distributions were similar for both periods, and median CD4 were 36 & 52 cell/µl, before and after the new guidelines implementation, respectively. 40.7% of patients had at least 1 missed/incorrect diagnosis before the new guidelines compared to 30% after new guidelines, p < 0.05. Clinical diagnosis for TB and toxoplasmosis were also much improved after the implementation of new guidelines. In addition, only 63% of patients had CD4 count test results before the new guidelines compared to 99% of patients after new guidelines. Death odds after the implementation of new guidelines were significantly lower than before new guidelines in a multivariate regression model that included patients CD4 count and 10 other covariates, p < 0.05. CONCLUSIONS: Simplification and implementation of a new and improved HIV clinical guideline coupled with the installation of laboratory equipment and point of care tests potentially helped reduce incorrect diagnosis and improve clinical outcomes of patients with advanced HIV. Regulating authorities should consider developing simplified versions of guidelines followed by the provision of basic diagnostic equipment to health centers.


Asunto(s)
Antirretrovirales/uso terapéutico , Infecciones por VIH/tratamiento farmacológico , Adolescente , Adulto , Instituciones de Atención Ambulatoria , Recuento de Linfocito CD4 , República Democrática del Congo , Femenino , Guías como Asunto , Infecciones por VIH/complicaciones , Infecciones por VIH/mortalidad , Mortalidad Hospitalaria , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Toxoplasmosis/complicaciones , Toxoplasmosis/diagnóstico , Tuberculosis/complicaciones , Tuberculosis/diagnóstico , Adulto Joven
3.
Lima; Perú. Ministerio de Salud; 1 ed; 20200900. 9 p. ilus.
Monografía en Español | LILACS, MINSAPERU | ID: biblio-1121873

RESUMEN

La publicación describe las pautas metodológicas como parte del acompañamiento psicosocial que se le brinda a una persona en estado de crisis; también contiene estrategias de afrontamiento funcionales frente a la crisis, es decir, desarrollar o fortalecer aquellos modos de pensar y actuar que facilitan la resolución de una situación percibida como demandante.


Asunto(s)
Adaptación Psicológica , Salud Mental , Guías como Asunto , Atención Integral de Salud , Primeros Auxilios
4.
Lima; Perú. Ministerio de Salud; 20200900. 30 p.
Monografía en Español | LILACS, MINSAPERU | ID: biblio-1118686

RESUMEN

El documento contiene los criterios administrativos para el adecuado tratamiento de los datos personales relacionados con la salud o datos personales en salud.


Asunto(s)
Sistemas de Información , Registros Médicos , Seguridad Computacional , Guías como Asunto
6.
Lancet Oncol ; 21(9): e444-e451, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32888473

RESUMEN

Population-based cancer registries (PBCRs) generate measures of cancer incidence and survival that are essential for cancer surveillance, research, and cancer control strategies. In 2014, the Toronto Paediatric Cancer Stage Guidelines were developed to standardise how PBCRs collect data on the stage at diagnosis for childhood cancer cases. These guidelines have been implemented in multiple jurisdictions worldwide to facilitate international comparative studies of incidence and outcome. Robust stratification by risk also requires data on key non-stage prognosticators (NSPs). Key experts and stakeholders used a modified Delphi approach to establish principles guiding paediatric cancer NSP data collection. With the use of these principles, recommendations were made on which NSPs should be collected for the major malignancies in children. The 2014 Toronto Stage Guidelines were also reviewed and updated where necessary. Wide adoption of the resultant Paediatric NSP Guidelines and updated Toronto Stage Guidelines will enhance the harmonisation and use of childhood cancer data provided by PBCRs.


Asunto(s)
Guías como Asunto/normas , Neoplasias/terapia , Pediatría/tendencias , Pronóstico , Niño , Prestación de Atención de Salud , Humanos , Estadificación de Neoplasias , Neoplasias/epidemiología , Sistema de Registros
7.
Diving Hyperb Med ; 50(3): 278-287, 2020 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-32957131

RESUMEN

Scuba diving is a critical activity for commercial industry, military activities, research, and public safety, as well as a passion for many recreational divers. Physicians are expected to provide return-to-diving recommendations after SARS-CoV-2 (COVID-19) infection based upon the best available evidence, often drawn from experience with other, similar diseases. Scuba diving presents unique physiologic challenges to the body secondary to immersion, increased pressure and increased work of breathing. The long-term sequelae of COVID-19 are still unknown, but if they are proven to be similar to other coronaviruses (such as Middle East respiratory syndrome or SARS-CoV-1) they may result in long-term pulmonary and cardiac sequelae that impact divers' ability to safely return to scuba diving. This review considers available literature and the pathophysiology of COVID-19 as it relates to diving fitness, including current recommendations for similar illnesses, and proposes guidelines for evaluation of divers after COVID-19. The guidelines are based upon best available evidence about COVID-19, as well as past experience with determination of diving fitness. It is likely that all divers who have contracted COVID-19 will require a medical evaluation prior to return to diving with emphasis upon pulmonary and cardiac function as well as exercise capacity.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Buceo , Guías como Asunto , Neumonía Viral/complicaciones , Reinserción al Trabajo , Betacoronavirus , Humanos , Pandemias
8.
Acta Biomed ; 91(3): e2020028, 2020 09 07.
Artículo en Inglés | MEDLINE | ID: mdl-32921723

RESUMEN

This article reviews the current knowledges of congenital bleeding disorders (CBD) amid the COVID-19 pandemic. It appears that CBD is not associated with higher risk of getting COVID-19 and so the prevalence of COVID-19 among them seems not higher compared to the general population. In absence of specific therapeutic recommendations, it is essential to make a correct assessment of the risk of haemorrhage/thrombosis. Based on expert opinion, strategies for outpatient management include adherence to prescribed regimens, telemedicine, and communication about COVID-19 in patients with CBD. More data should be also collected to better characterize the impact of COVID-19 on patients with CBD. The current findings encourage further studies to determine the prevalence of SARS-CoV2 infection in CBD patients to understand more fully the burden of this novel pathogen and to develop adequate preventive measures against this infection.


Asunto(s)
Betacoronavirus , Trastornos de la Coagulación Sanguínea Heredados/epidemiología , Infecciones por Coronavirus/epidemiología , Manejo de la Enfermedad , Guías como Asunto , Pandemias , Neumonía Viral/epidemiología , Telemedicina/métodos , Trastornos de la Coagulación Sanguínea Heredados/terapia , Humanos , Pacientes Ambulatorios
9.
S Afr Med J ; 110(7): 635-639, 2020 06 05.
Artículo en Inglés | MEDLINE | ID: mdl-32880338

RESUMEN

Research is imperative in addressing the COVID-19 epidemic, both in the short and long term. Informed consent is a key pillar of research and should be central to the conduct of COVID-19 research. Yet a range of factors, including physical distancing requirements, risk of exposure and infection to research staff, and multiple pressures on the healthcare environment, have added layers of challenges to the consent process in COVID-19 patients. Internationally, the recognition that consent for COVID-19 research may be imperfect has led to a range of suggestions to ensure that research remains ethical. Drawing on these guidelines, we propose a consent process for COVID-19 research in the South African context that combines individual consent with delayed and proxy consent for individuals who may be temporarily incapacitated, combined with key principles that should be considered in the design of a consent process for COVID-19 research.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Bases de Datos Factuales/ética , Guías como Asunto , Consentimiento Informado/ética , Pandemias/estadística & datos numéricos , Neumonía Viral/epidemiología , Control de Enfermedades Transmisibles/normas , Infecciones por Coronavirus/prevención & control , Países en Desarrollo , Femenino , Humanos , Masculino , Pandemias/prevención & control , Neumonía Viral/prevención & control , Proyectos de Investigación , Sudáfrica
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1192-1194, 2020 Aug 10.
Artículo en Chino | MEDLINE | ID: mdl-32867423

RESUMEN

As an emerging infectious disease, the COVID-19 threatened the safety of personnel in the prevention and control during the COVID-19 pandemic. Beijing Association of Preventive Medicine organizes the Beijing CDC and other organizations drafted the group standard entitled "Guidelines for personal protection against coronavirus disease 2019 for diseases control person (T/BPMA 0002-2020)" , according to years of scientific research on personal protection. Based on the principles of emphasizing the scientific, normative and safe nature, the standard was drafted to put forward the reasonable selection and correct use of personal protective equipment for disease control personnel, as well as the procedures for personal protective equipment. The standard provided a standardized basis for ensuring the safety of disease control personnel in contacting and handling of the new coronary pneumonia outbreaks with high risks.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Coronavirus , Guías como Asunto , Control de Infecciones/normas , Pandemias/prevención & control , Equipo de Protección Personal/normas , Neumonía Viral/prevención & control , Betacoronavirus , China , Infecciones por Coronavirus/epidemiología , Personal de Salud , Humanos , Control de Infecciones/métodos , Neumonía Viral/epidemiología
15.
Hosp. domic ; 4(3): 133-152, jul.-sept. 2020. ilus, tab, graf
Artículo en Español | IBECS | ID: ibc-192943

RESUMEN

PROPÓSITO: Ante la crisis sanitaria que vive el país y el mundo actualmente, se confeccionó este documento por la iniciativa autónoma de kinesiólogos de doce unidades de Hospitalización Domiciliaria (HD) de hospitales públicos de Chile, con el fin de unificar criterios en base a sus experiencias y la evidencia científica disponible para poder realizar una atención kinésica respiratoria segura en pacientes con sospecha o confirmados para COVID-19. Además, este documento tiene el objetivo de ser una guía para quienes tengan la necesidad de protocolizar y/o estandarizar su atención en HD, pudiendo ser adaptado según la necesidad y disponibilidad de recursos e infraestructura de cada unidad. Es importante señalar, que este documento puede variar según la evolución de esta pandemia y la actualización de la evidencia científica. CAMPO DE APLICACIÓN: Este documento está diseñado para ser aplicado en el domicilio de los pacientes adultos y pediátricos ingresados a las Unidades de Hospitalización Domiciliaria (UHD) con sospecha de infección por SARS-CoV-2 o con resultado positivo para COVID-19


PURPUSE: Given the health crisis that the country and the world are currently experiencing, this document was prepared by the autonomous initiative of kinesiologists from twelve Hospital at Home units of public hospitals in Chile, in order to unify criteria based on their experiences and the available scientific evidence in order to carry out safe respiratory physiotherapy care in patients with suspected or confirmed COVID-19. In addition, this document is intended to be a guide for those who need to protocolize and / or standardize their care at Hospital at home, and can be adapted according to the need and availability of resources and infrastructure of each unit. It is important to note that this document may vary depending on the evolution of this pandemic and the updating of scientific evidence. SCOPE: This document is designed to be applied in the home of adult and pediatric patients admitted to Hospital at Home Units (UHD) with suspected SARS-CoV-2 infection or with a positive result for COVID-19


Asunto(s)
Humanos , Ejercicios Respiratorios/métodos , Síndrome Respiratorio Agudo Grave/rehabilitación , Virus del SRAS/patogenicidad , Infecciones por Coronavirus/epidemiología , Modalidades de Fisioterapia/organización & administración , Servicios de Atención a Domicilio Provisto por Hospital/organización & administración , Control de Enfermedades Transmisibles/métodos , Ventilación no Invasiva/estadística & datos numéricos , Precauciones Universales/métodos , Guías como Asunto
16.
Radiographics ; 40(5): 1309-1317, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32870768

RESUMEN

The recent shutting down of in-person events owing to the coronavirus disease 2019 (COVID-19) pandemic has elevated the popularity of web-based conferencing. This development provides an opportunity for educators to test their teaching skills on what, for many, is a new platform. Many of the basic elements of what constitutes an effective presentation are the same regardless of whether they are delivered in person or online. However, there are advantages and disadvantages of each mode of presentation, and understanding how to best leverage the features of an online platform will lead to a better educational experience for the presenter and audience. The effectiveness of any presentation is dependent on the ability of the speaker to communicate with the audience. This is accomplished by including as much audience participation as possible. Many of the techniques used to encourage audience participation in person can be adapted for use in online presentations (eg, the use of features such as chat, hand raising, polling, and question-and-answer sessions). In any type of presentation, both the quality of the content and the oral delivery are important. The author reviews the common elements of an effective presentation and how they can be optimized for online platforms. ©RSNA, 2020.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Internet , Pandemias , Neumonía Viral , Radiología/métodos , Comunicación por Videocoferencia , Infecciones por Coronavirus/prevención & control , Presentación de Datos , Guías como Asunto , Humanos , Mercadotecnía , Pandemias/prevención & control , Neumonía Viral/prevención & control , Radiología/tendencias , Habla , Comunicación por Videocoferencia/organización & administración , Comunicación por Videocoferencia/tendencias
17.
Health Lit Res Pract ; 4(3): e161-e165, 2020 08 06.
Artículo en Inglés | MEDLINE | ID: mdl-32926171

RESUMEN

Stay-at-home orders have been an essential component of coronavirus 2019 (COVID-19) management in the United States. As states start lifting these mandates to reopen the economy, voluntary public compliance with public health recommendations may significantly influence the extent of resurgence in COVID-19 infection rates. Population-level risk from reopening may therefore be predicted from public intent to comply with public health recommendations. We are conducting a global, convergent design mixed-methods survey on public knowledge, perceptions, preferred health information sources, and understanding of and intent to comply with public health recommendations. With over 9,000 completed surveys from every US state and over 70 countries worldwide, to our knowledge this is the largest pandemic messaging study to date. Although the study is still ongoing, we have conducted an analysis of 5,005 US surveys completed from April 9-15, 2020 on public intent to comply with public health recommendations and offer insights on the COVID-19 pandemic-related risk of reopening. We found marked regional differences in intent to follow key public health recommendations. Regional efforts are urgently needed to influence public behavior changes to decrease the risk of reopening, particularly in higher-risk areas with low public intent to comply with preventive health recommendations. [HLRP: Health Literacy Research and Practice. 2020;4(3):e160-e165.].


Asunto(s)
Actitud Frente a la Salud , Infecciones por Coronavirus/prevención & control , Intención , Pandemias/prevención & control , Neumonía Viral/prevención & control , Salud Pública , Conducta Social , Adulto , Betacoronavirus , Comunicación , Coronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Femenino , Guías como Asunto , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Neumonía Viral/epidemiología , Neumonía Viral/virología , Aislamiento Social , Encuestas y Cuestionarios , Estados Unidos
18.
Health Lit Res Pract ; 4(3): e166-e170, 2020 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-32926172

RESUMEN

By mid-May 2020, most of the United States had been under shelter-in-place orders for several weeks to decrease the spread of coronavirus 2019 (COVID-19). As states begin to lift these orders to reopen the economy, the risk of a resurgence of COVID-19 may be related to the public's voluntary adherence to public health recommendations. We conducted a nationally representative survey of 604 African Americans to generate a risk assessment based on African Americans' compliance with public health recommendations to frequently wash hands, maintain social distancing, avoid touching face, and wear a mask in public. This is, to our knowledge, the most comprehensive study of African Americans and public health adherence specific to COVID-19. The percent of respondents reporting that they always comply with these recommendations was 72%, 67%, 55%, and 65%, respectively. Based on this threshold, African Americans' level of adherence with COVID-19 public health recommendations suggests they may be at high risk of a resurgence of COVID-19 during reopening, and there is an urgent need for targeted, culturally responsive public health messaging that is accessible to communities of color to help address racial disparities in COVID-19 risk. [HLRP: Health Literacy Research and Practice. 2020;4(3):e166-e170.].


Asunto(s)
Afroamericanos , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Salud Pública , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Cara , Femenino , Guías como Asunto , Desinfección de las Manos , Humanos , Masculino , Máscaras , Neumonía Viral/epidemiología , Neumonía Viral/virología , Medición de Riesgo , Aislamiento Social , Estados Unidos
20.
Work ; 66(4): 713-716, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32925132

RESUMEN

BACKGROUND: The primary response to the coronavirus (COVID-19) pandemic has been to minimize social contact through lockdown measures. The closure of non-essential businesses to tackle the spread of the coronavirus has had negative consequences for the global economy, production, and employment. OBJECTIVE: To outline how known occupational health principles can be used for preventative management of the coronavirus in workplaces to support resumption of work. METHODS: A discussion of current knowledge of COVID-19, the cost of the lockdown strategy, and preventative biological cycle management. RESULTS: The evidence-based literature indicates that biological cycle management can control the risk of coronavirus infection, provide a suitable and sufficient exit strategy from lockdown, and support getting employees back to work. Adherence to personal protective equipment standards has been insufficient, indicating a need for workplace investment and education. CONCLUSION: Imposed restrictions on workplace operations can be lifted without compromising worker health and safety when a workplace commits to practicing the three principles of biological cycle management.


Asunto(s)
Betacoronavirus/patogenicidad , Infecciones por Coronavirus/prevención & control , Salud Laboral , Pandemias/prevención & control , Neumonía Viral/prevención & control , Cuarentena/normas , Reinserción al Trabajo , Lugar de Trabajo/organización & administración , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Guías como Asunto , Higiene de las Manos/normas , Humanos , Equipo de Protección Personal/normas , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Neumonía Viral/virología , Cuarentena/organización & administración , Factores de Tiempo
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