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5.
J Med Syst ; 45(4): 42, 2021 Feb 19.
Artículo en Inglés | MEDLINE | ID: mdl-33608811

RESUMEN

In confronting the sudden epidemic of COVID-19, China and other countries have been under great deal of pressure to block virus transmission and reduce death cases. Fangcang shelter hospital, which is converted from large-scale public venue, is proposed and proven to be an effective way for administering medical care and social isolation. This paper presents the practice in information technology support for a Fangcang shelter hospital in Wuhan, China. The experiences include the deployment strategy of IT infrastructure, the redesign of function modules in the hospital information system (HIS), equipment maintenance and medical staff training. The deployment strategy and HIS modules have ensured smoothness and efficiency of clinical work. The team established a quick response mechanism and adhered to the principle of nosocomial infection control. Deployment of network and modification of HIS was finished in the 48 hours before patient admittance. A repair hotline and remote support for equipment and software were available whenever medical workers met with any questions. No engineer ever entered the contaminated areas and no one was infected by the coronavirus during the hospital operation. Up to now, Fangcang shelter hospital is adopted by many regions around the world facing the collapse of their medical systems. This valuable experience in informatization construction and service in Wuhan may help participators involving in Fangcang shelter hospital get better information technology support, and find more practical interventions to fight the epidemic.


Asunto(s)
COVID-19/terapia , Refugio de Emergencia/organización & administración , Hospitales Especializados/organización & administración , Unidades Móviles de Salud/organización & administración , Aislamiento de Pacientes/estadística & datos numéricos , COVID-19/epidemiología , China , Urgencias Médicas , Arquitectura y Construcción de Instituciones de Salud , Hospitales de Aislamiento , Humanos , Tecnología de la Información , Factores de Riesgo
6.
Eur Rev Med Pharmacol Sci ; 25(1): 498-502, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33506941

RESUMEN

OBJECTIVE: The study aimed to explore the effects of psychological intervention on alleviating anxiety in patients in novel coronavirus (2019-nCoV) isolation wards. PATIENTS AND METHODS: Between January 24th, 2020 and March 5th, 2020, 103 patients were studied. Among these, 32 were patients in the isolation ward of the Infectious Disease Department in Baoding Second Hospital with suspected 2019-nCoV, and 71 patients diagnosed with 2019-nCoV were in the Tangshan Infectious Disease Hospital. Of the 103 patients included, 97 cases were observed in isolation. Using a self-control study design, each patient's anxiety was scored on a self-rating anxiety scale before receiving the psychological intervention (on the 7th day of isolation) and after receiving the intervention (on the 14th day of isolation). The severity of anxiety was evaluated based on the anxiety score before receiving the intervention. The anxiety scores before and after receiving the intervention were then compared using the paired t-test, and p<0.05 was considered statistically significant. RESULTS: After receiving the psychological intervention once or twice a week, the anxiety of the patients improved significantly after one week. CONCLUSIONS: The anxiety of patients with 2019-nCoV in isolation wards can be alleviated through psychological intervention. By alleviating patient anxiety, this intervention also helps patients maintain their psychological wellbeing, which promotes rehabilitation and helps with the control of 2019-nCoV.


Asunto(s)
Ansiedad/prevención & control , COVID-19/psicología , Hospitales de Aislamiento , Intervención Psicosocial/métodos , Calidad de Vida/psicología , Adaptación Psicológica , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Ansiedad/psicología , China , Autoevaluación Diagnóstica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Escalas de Valoración Psiquiátrica , SARS-CoV-2 , Encuestas y Cuestionarios , Adulto Joven
7.
Int J Med Sci ; 18(3): 646-651, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33437199

RESUMEN

Objectives: A significant proportion of discharged COVID-19 patients still have some symptoms. Traditional Chinese medicine (TCM) has played an important role in the treatment of COVID-19, but whether it is helpful for discharged patients is still unknown. The aim of this study was to retrospectively analyze the impacts of TCM treatment on the convalescents of COVID-19. Methods: A total of 372 COVID-19 convalescents from February 21 to May 3 in Shenzhen, China were retrospectively analyzed, 291 of them accepted clinically examined at least once and 191 convalescents accepted TCM. Results: After retrospective analysis of the clinical data of convalescents accepted TCM treatment or not, we found that the white blood cell count, as well as serum interleukin-6 and procalcitonin decreased in TCM group. Serum γ-glutamyl transpeptidase was significantly decreased, while prealbumin and albumin increased in TCM group. Red blood cell, hemoglobin, and platelet count increased in TCM group. The mechanisms of TCM treatment might be the overall regulations, including balanced immune response, improved hematopoiesis and coagulation systems, enhanced functions of liver and heart, increased nutrient intake and lipid metabolism. Conclusions: This study suggested that TCM treatment would be beneficial for discharged COVID-19 patients. However, long-term medical observation and further study with randomized trial should be done to confirm this result. Besides, the potential molecular mechanisms of TCM treatment should be further revealed.


Asunto(s)
COVID-19/rehabilitación , Convalecencia , Medicamentos Herbarios Chinos/administración & dosificación , COVID-19/sangre , COVID-19/diagnóstico , Hospitales de Aislamiento/estadística & datos numéricos , Humanos , Estudios Retrospectivos , SARS-CoV-2/aislamiento & purificación , Resultado del Tratamiento
8.
Minerva Obstet Gynecol ; 73(2): 261-267, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33435661

RESUMEN

BACKGROUND: Since COVID-19 was declared a pandemic, governments have taken actions to limit the transmission of the virus such as lockdown measures and reorganization of the local Health System. Quarantine measures have influenced pregnant women's daily lives. The aim of this study was to understand the impact of the changes imposed by COVID-19 emergency on the well-being of pregnant women and how the transformation of Schiavonia Hospital into a dedicated COVID hospital affected their pregnancy experience. METHODS: A cross-sectional survey was conducted. Pregnant women who gave birth in Schiavonia Hospital during the period May-September 2020 have been included. The assessment examined clinical characteristics, attitudes in relation to the pandemic and how it affected birth plans, perception of information received, and attitudes regards giving birth in a COVID hospital. RESULTS: One hundred four women responded to the survey, with an enrolment rate of 58%. About the influence of COVID-19 pandemic, 51% of respondents reported changing some aspect of their lifestyle. The identification of Schiavonia Hospital as COVID hospital did not modify the trust in the facility and in the obstetrics ward for the 90% of women, in fact for the 85.6% it was the planned Birth Center since the beginning of pregnancy. The communication was complete and exhaustive for 82.7% of the respondents. CONCLUSIONS: Despite the COVID hospital transformation, the women who came to give birth at Schiavonia Birth Center rated the healthcare assistance received at high level, evidencing high affection for the structure and the healthcare workers.


Asunto(s)
Actitud Frente a la Salud , COVID-19/epidemiología , Salas de Parto/organización & administración , Parto Obstétrico , Mujeres Embarazadas/psicología , Adulto , Estudios Transversales , Femenino , Clausura de las Instituciones de Salud , Hospitales de Aislamiento/organización & administración , Humanos , Italia/epidemiología , Estilo de Vida , Pandemias , Paridad , Embarazo , Atención Prenatal/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , Mujeres Trabajadoras/estadística & datos numéricos , Adulto Joven
9.
Am J Infect Control ; 49(4): 447-451, 2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-32841686

RESUMEN

BACKGROUND: Coronavirus disease 2019 has spread globally and been a public health emergency worldwide. It is important to reduce the risk of healthcare associated infections among the healthcare workers and patients. This study aimed to investigate the contamination of environment in isolation wards and sewage, and assess the quality of routine disinfection procedures in our hospital. METHODS: Routine disinfection procedures were performed 3-times a day in general isolation wards and 6-times a day in isolated ICU wards in our hospital. Environmental surface samples and sewage samples were collected for viral RNA detection. Severe acute respiratory syndrome coronavirus 2 RNA detection was performed with quantitative reverse transcription polymerase chain reaction. RESULTS: A total of 163 samples were collected from February 6 to April 4. Among 122 surface samples, 2 were positive for severe acute respiratory syndrome coronavirus 2 RNA detection. One was collected from the flush button of the toilet bowl, and the other was collected from a hand-basin. Although 10 of the sewage samples were positive for viral RNA detection, all positive samples were negative for viral culture. CONCLUSION: These results revealed the routine disinfection procedures in our hospital were effective in reducing the potential risk of healthcare associated infection. Two surface samples were positive for viral detection, suggesting that more attention should be paid when disinfecting places easy to be ignored.


Asunto(s)
COVID-19/prevención & control , Desinfección/métodos , Hospitales de Aislamiento/normas , SARS-CoV-2 , Desinfección/normas , Personal de Salud , Humanos , Exposición Profesional/prevención & control
10.
Am J Trop Med Hyg ; 104(1): 85-90, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33205749

RESUMEN

Globally, India has reported the third highest number of COVID-19 cases. Chennai, the capital of Tamil Nadu state, witnessed a huge surge in COVID-19 cases, resulting in the establishment of isolation facilities named COVID Care Center (CCC). In our study, we describe the demographic, epidemiological, and clinical characteristics; clinical progression; and outcome of 1,263 asymptomatic/mildly symptomatic COVID-19 patients isolated in one such CCC between May 4, 2020 and June 4, 2020. Around 10.5% of the patients progressed to moderate/severe illness, requiring referral for tertiary care, and three died. Nearly half (49.5%) of the patients were symptomatic at the time of admission, 2.2% of the patients developed symptoms post-testing, and 48.5% patients remained asymptomatic during the entire course of illness. Most common presenting symptoms were fever (69.9%) and cough (29.6%), followed by generalized body pain, breathlessness, and loss of smell and taste. On multivariate analysis, we identified that symptomatic patients with comorbidities and higher neutrophil-lymphocyte ratio (NLR) were more likely to progress to severe illness warranting referral for tertiary care. COVID Care Center ensured case isolation and monitoring of asymptomatic/mildly symptomatic patients, thereby providing hospital beds for sick patients. COVID Care Center isolation facilities are safe alternatives for medical institutions to isolate and monitor COVID-19 patients. Older symptomatic patients with comorbidities and a high NLR admitted in an isolation facility must be frequently monitored for prompt identification of clinical progression and referral to higher center for advanced medical care.


Asunto(s)
COVID-19/epidemiología , COVID-19/patología , Hospitales de Aislamiento , SARS-CoV-2 , Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , India/epidemiología , Lactante , Masculino , Persona de Mediana Edad , Adulto Joven
15.
Nurs Open ; 7(6): 1902-1908, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33346408

RESUMEN

AIM: To explore an effective personalized training model for nurses working in emergency isolation wards of COVID-19 in a short period. DESIGN: This study is a longitudinal study from 24 January 2020 to 28 February 2020. METHODS: There are 71 nursing staff working in the emergency isolation wards of Sichuan Provincial People's Hospital that participated in this study. The questionnaires were conducted with Likert scale. The operation assessment teachers have received standardized training. The self-rating anxiety scale (SAS) and self-rating depression Scale (SDS) were applied to assess the mental state of nurses. RESULTS: After short-term training, these nurses can handle the emergency tasks in a timely manner. The pass rate of nurse theory and operation assessment is 100%. The 111 suspected patients admitted to the emergency isolation ward have been scientifically diagnosed and treated, the three confirmed patients have received appropriate treatment. No nurses have been infected. CONCLUSIONS: In this study, the personalized emergency training mode was feasible in the emergency isolation ward during the COVID-19 epidemic, which rapidly improved the rescue ability of nurses and effectively avoid the occurrence of cross-infection. This mode can provide a valuable reference for the emergency training of nurses in the future.


Asunto(s)
COVID-19/enfermería , Servicio de Urgencia en Hospital/organización & administración , Hospitales de Aislamiento/organización & administración , Personal de Enfermería en Hospital/educación , Adulto , China , Femenino , Humanos , Control de Infecciones/organización & administración , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Personal de Enfermería en Hospital/psicología , Estrés Laboral/prevención & control , Pandemias , SARS-CoV-2 , Encuestas y Cuestionarios
16.
Fontilles, Rev. leprol ; 32(6): 411-439, sept.-dic. 2020. mapas, tab, ilus
Artículo en Español | IBECS | ID: ibc-199932

RESUMEN

Los colonizadores holandeses en Surinam afirmaban que la lepra (o enfermedad de Hansen) era muy contagiosa y se transmitía entre humanos. Se construyó un "cordón sanitario" alrededor de los pacientes, sobre todo esclavos africanos y asiáticos contratados como trabajadores y sus descendientes. Se les perseguía y eran recluidos en aldeas para afectados de lepra muy remotas localizadas en la selva tropical. Algunos pacientes obedecieron a las autoridades, mientras que otros resistieron y se rebelaron. Sus historias revelan conceptos confusos sobre la enfermedad con su cultura y el medioambiente surinamés, y contienen importantes informaciones para comprender su mundo y la vida dentro y fuera de las colonias para lepra. Combinaban prácticas sanitarias tradicionales y plantas medicinales de su hábitat natural con tratamientos biomédicos (practicando un pluralismo médico). Creían en una gran variedad de explicaciones sobre la enfermedad, predominantemente los conceptos tabúes treef, tyina y animales tótem asociados con su hábitat natural (el bioma surinamés). Algunas de las explicaciones de su imaginario (por ejemplo, la lepra es transmitida por la tierra y ciertos animales) revelan una analogía sorprendente con descubrimientos científicos recientes. Nuestra investigación revela que la naturaleza contribuye a moldear el mundo de los pacientes de Hansen. Un planteamiento ecológico puede contribuir significativamente a la hora de comprender su mundo. Hay que efectuar una investigación histórica y antropológica comparativa para trazar la influencia de distintos biomas sobre los modelos locales. Las colonias de Hansen actualmente abandonadas y sus entornos naturales son lugares importantes para el patrimonio cultural


According to the Dutch colonizers in Suriname, leprosy (or Hansen's disease) was highly contagious and transmitted from human-to-human. A "cordon sanitaire" was constructed around the patients, mainly African slaves and Asian indentured laborers and their descendants. They were tracked down and incarcerated in remote leprosy settlements located in the rainforest. Some patients obeyed the authorities while others resisted and rebelled. Their narratives, revealing conceptual entanglement of the disease with their culture and the Surinamese natural environment, contain important information for understanding their world and their life inside and outside of leprosy settlements. They combined traditional health practices and medicinal plants from their natural habitat with biomedical treatments (practicing medical pluralism). They believed in a diversity of disease explanations, predominantly the taboo concepts treef, tyina, and totem animals associated with their natural habitat (the Surinamese biome). Some of their imaginary explanations (e.g., "leprosy is carried and/or transmitted through soil and certain animals") show a surprising analogy with recent findings from leprosy scientists. Our research shows that nature contributes to shaping the world of Hansen's disease patients. An ecological approach can make a valuable contribution to understanding their world. Comparative historical and anthropological research needs to be conducted to map the influence of different biomes on local explanatory models. The now deserted Hansen's disease settlements and their natural environments are interesting research sites and important places of cultural heritage


Asunto(s)
Humanos , Historia del Siglo XVIII , Historia del Siglo XIX , Historia del Siglo XX , Lepra/historia , Colonialismo/historia , Lepra/prevención & control , Lepra/terapia , Entrevistas como Asunto , Factores Socioeconómicos , Pacientes/psicología , Características Culturales , Suriname/etnología , Hospitales de Aislamiento/historia , Cuarentena/historia , Aislamiento de Pacientes/historia
17.
Eur Rev Med Pharmacol Sci ; 24(20): 10867-10873, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33155249

RESUMEN

OBJECTIVE: To summarize the experience of three Chinese cities (Wuhan, Shanghai and Haikou) and provide a reference for global efforts to combat COVID-19 spread among children. MATERIALS AND METHODS: Through collecting the measures and outcomes of preventing and controlling COVID-19 in China's three hospitals, we compared the effect of different strategies. RESULTS: From January to March 2020, the number of suspected and confirmed COVID-19 cases in Wuhan increased exponentially, and Wuhan Children's Hospital as a whole was transformed into a designated quarantine and treatment facility, which is the "Wuhan Model". Shanghai has more children's hospitals with better capabilities to tackle public health emergency. Besides, it is far away from Wuhan and had a small caseload. Children's Hospital of Fudan University, a facility in Shanghai to treat pediatric infectious diseases, is famous for its well-equipped building for infectious disease treatment and professional medical team, and therefore no major transformation was required. That is the "Shanghai Model". Haikou is located on an island. Amid the outbreak, large numbers of tourists and travelers from Hubei had already arrived in Haikou. Hainan Women and Children's Medical Center, as the only pediatric care hospital in Hainan Province, did not have a separate building for infectious disease treatment. After a citywide survey of the medical resources and facilities available, a temporarily idle hospital 3 kilometers away from Hainan Women and Children's Medical Center was requisitioned as the quarantine and treatment facility for pediatric cases. That is the "Hainan Model". The three models enabled the treatment of all suspected and confirmed cases and no fatality was reported. CONCLUSIONS: The COVID-19 coping strategies for children should be designed according to the existing conditions of the local children's hospitals and the risk levels of the epidemic.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Hospitales de Aislamiento/organización & administración , Hospitales Pediátricos/organización & administración , Pandemias/prevención & control , Neumonía Viral/prevención & control , Adaptación Psicológica , Adolescente , COVID-19 , Niño , Preescolar , China/epidemiología , Femenino , Humanos , Lactante , Masculino
19.
Int J Gynaecol Obstet ; 151(3): 341-346, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33011974

RESUMEN

OBJECTIVE: To determine the impact of roster reorganization on ensuring uninterrupted services while providing necessary relief to healthcare workers (HCW) in the obstetrics department of a tertiary care center amid the COVID-19 outbreak. METHODS: The COVID-19 rostering response began in April 2020 and evolved in two phases: (1) development of new areas for screening and managing suspected/positive cases of COVID-19; and (2) team segregation according to area of work. The impact of these changes on HCWs and patients was assessed 3 months later. RESULTS: Developing separate areas helped to minimize the risk of exposure of patients and HCWs to those with COVID-19. Residents and consultants worked intensively in clinical areas for 1 week followed by 1-2 weeks of non-clinical or standby assignments, providing adequate opportunity for isolation. Frequent re-evaluation of the roster was nevertheless required as the pandemic progressed. Segregating teams vertically significantly reduced the number of contacts identified on contact tracing and quarantine leaves, while maintaining patient satisfaction with no increase in adverse events. Residents found the roster to be "smart" and "pandemic-appropriate." CONCLUSION: The "COVID emergency roster" helped ensure quality care with minimum risk of exposure and sufficient breaks for physical and psychological recovery of HCWs.


Asunto(s)
COVID-19/prevención & control , Hospitales de Aislamiento/organización & administración , Admisión y Programación de Personal/organización & administración , Adulto , COVID-19/diagnóstico , COVID-19/terapia , Femenino , Ginecología/métodos , Humanos , India , Masculino , Obstetricia/métodos , Pandemias , Embarazo , SARS-CoV-2 , Centros de Atención Terciaria/organización & administración , Adulto Joven
20.
J Med Internet Res ; 22(10): e19878, 2020 10 14.
Artículo en Inglés | MEDLINE | ID: mdl-33001832

RESUMEN

BACKGROUND: As the COVID-19 epidemic increases in severity, the burden of quarantine stations outside emergency departments (EDs) at hospitals is increasing daily. To address the high screening workload at quarantine stations, all staff members with medical licenses are required to work shifts in these stations. Therefore, it is necessary to simplify the workflow and decision-making process for physicians and surgeons from all subspecialties. OBJECTIVE: The aim of this paper is to demonstrate how the National Cheng Kung University Hospital artificial intelligence (AI) trilogy of diversion to a smart quarantine station, AI-assisted image interpretation, and a built-in clinical decision-making algorithm improves medical care and reduces quarantine processing times. METHODS: This observational study on the emerging COVID-19 pandemic included 643 patients. An "AI trilogy" of diversion to a smart quarantine station, AI-assisted image interpretation, and a built-in clinical decision-making algorithm on a tablet computer was applied to shorten the quarantine survey process and reduce processing time during the COVID-19 pandemic. RESULTS: The use of the AI trilogy facilitated the processing of suspected cases of COVID-19 with or without symptoms; also, travel, occupation, contact, and clustering histories were obtained with the tablet computer device. A separate AI-mode function that could quickly recognize pulmonary infiltrates on chest x-rays was merged into the smart clinical assisting system (SCAS), and this model was subsequently trained with COVID-19 pneumonia cases from the GitHub open source data set. The detection rates for posteroanterior and anteroposterior chest x-rays were 55/59 (93%) and 5/11 (45%), respectively. The SCAS algorithm was continuously adjusted based on updates to the Taiwan Centers for Disease Control public safety guidelines for faster clinical decision making. Our ex vivo study demonstrated the efficiency of disinfecting the tablet computer surface by wiping it twice with 75% alcohol sanitizer. To further analyze the impact of the AI application in the quarantine station, we subdivided the station group into groups with or without AI. Compared with the conventional ED (n=281), the survey time at the quarantine station (n=1520) was significantly shortened; the median survey time at the ED was 153 minutes (95% CI 108.5-205.0), vs 35 minutes at the quarantine station (95% CI 24-56; P<.001). Furthermore, the use of the AI application in the quarantine station reduced the survey time in the quarantine station; the median survey time without AI was 101 minutes (95% CI 40-153), vs 34 minutes (95% CI 24-53) with AI in the quarantine station (P<.001). CONCLUSIONS: The AI trilogy improved our medical care workflow by shortening the quarantine survey process and reducing the processing time, which is especially important during an emerging infectious disease epidemic.


Asunto(s)
Inteligencia Artificial , Betacoronavirus , Cuarentena , Adulto , COVID-19 , Infecciones por Coronavirus , Femenino , Hospitales de Aislamiento , Humanos , Persona de Mediana Edad , Pandemias , Neumonía Viral , Cuarentena/métodos , SARS-CoV-2 , Encuestas y Cuestionarios , Taiwán/epidemiología
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