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1.
J Glob Health ; 11: 05007, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33791096

RESUMEN

Background: Respiratory syncytial virus (RSV) and influenza are prevalent seasonal community viruses. Although not completely understood, SARS-CoV-2 may have the same means of transmission. Preventive social measures aimed at preventing SARS-CoV-2 spread could impact transmission of other respiratory viruses as well. The aim of this study is to report the detection of RSV and influenza during the period of social distancing due to COVID-19 pandemic in a heavily affected community. Methods: Prospective study with pediatric and adult populations seeking care for COVID-19-like symptoms during the fall and winter of 2020 at two hospitals in Southern Brazil. RT-PCR tests for SARS-CoV-2, influenza A (Flu A), influenza B (Flu B) and respiratory syncytial virus (RSV) was performed for all participants. Results: 1435 suspected COVID-19 participants (1137 adults, and 298 children). were included between May and August. Median age was 37.7 years (IQR = 29.6-47.7), and 4.92 years (IQR = 1.96-9.53), for the adult and child cohorts, respectively. SARS-CoV-2 was positive in 469 (32.7%) while influenza and RSV were not detected at all. Conclusions: Measures to reduce SARS-CoV-2 transmission likely exerted a huge impact in the spread of alternate respiratory pathogens. These findings contribute to the knowledge about the dynamics of virus spread. Further, it may be considered for guiding therapeutic choices for these other viruses.


Asunto(s)
/prevención & control , Virus de la Influenza A/aislamiento & purificación , Virus de la Influenza B/aislamiento & purificación , Gripe Humana/diagnóstico , Infecciones por Virus Sincitial Respiratorio/diagnóstico , Virus Sincitiales Respiratorios/aislamiento & purificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Brasil/epidemiología , /epidemiología , Niño , Preescolar , Femenino , Hospitales , Humanos , Lactante , Gripe Humana/transmisión , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Infecciones por Virus Sincitial Respiratorio/transmisión , Estaciones del Año , Adulto Joven
3.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(2): 620-628, 2021 Apr.
Artículo en Chino | MEDLINE | ID: mdl-33812441

RESUMEN

OBJECTIVE: To analyze the use of blood products in patients at different ages. METHODS: The clinical datas of the 10 784 patients transfused in Sichuan provincial people's hospital at 2017-2018 were retrospectively analyzed, and the basic condition of clinical blood using was statistically described. The patients were divided into the groups according to age and disease, then the use of various blood products in the patients with different diseases in different age groups was analyzed. RESULTS: The age of blood transfusion patients was mainly 40-80 years old, and the most common disease was tumor(about 28%). The average annual transfusion volumes of red blood cells(RBC) were 24 936.5 U, of platelets(PLT) were 3 795 therapeutic doses of plasma were 2 455 500 ml, of cryoprecipitate were 3 461.5 U in our hospital. Most patients with hematologic malignancies and liver cirrhosis were transfused with two or more blood productions. For the patients with hematologic malignancies, the irradiated RBC (76.4%), PLT (67.8%), and suspended RBC (59.9%) were commonly used. And for liver cirrhosis patients, the suspended RBC (64.2%) and fresh frozen plasma(FFP) (59.4%) were commonly used. For the patients with trauma and chronic kidney disease(CKD), the suspended RBC (95.7% and 91.5%, respectively) was commonly used. In hematologic malignancies patients, the transfusion volume of irradiated RBC, PLT and FFP in the patients aged ≥60 years old was lower than that in patients aged<60 years old (P<0.05); in trauma patients, the transfusion volume of suspended RBC in the patients aged ≥60 years old was lower than that in patients aged<60 years old (P<0.05). In hematologic malignancies, trauma and liver cirrhosis patients, the proportion of PLT and/or plasma transfusion in the patients aged ≥60 years old was lower than that in patients aged<60 years old (P<0.05), and the elderly patients were more likely to receive RBC transfusion only. CONCLUSION: There is a difference in the distribution of blood product between the patients aged<60 years old and ≥60 years old in the same disease, and it is more likely that the elderly patients (aged ≥60 years old) receive RBC transfusion only, and correction of hypoxia is a major clinical consideration, so blood using plans should be made according to the patient population, moreover, the different transfusion strategies should be developed for different population to maximize the efficiency of blood using.


Asunto(s)
Transfusión de Componentes Sanguíneos , Plasma , Adulto , Anciano , Anciano de 80 o más Años , Transfusión Sanguínea , Hospitales , Humanos , Persona de Mediana Edad , Estudios Retrospectivos
4.
Int Breastfeed J ; 16(1): 30, 2021 03 31.
Artículo en Inglés | MEDLINE | ID: mdl-33789708

RESUMEN

BACKGROUND: The World Health Organization recognizes exclusive breastfeeding a safe source of nutrition available for children in most humanitarian emergencies, as in the current pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Despite the Brazilian national guideline protecting breastfeeding practices, there are many concerns about protecting infants from their infected mothers. This study aimed to analyze how the Brazilian hospitals and maternity services promote and support mothers suspected or diagnosed with coronavirus disease (COVID-19). METHODS: This is a descriptive cross-sectional and multicenter study which collected data from 24 Brazilian hospitals and maternity services between March and July 2020. Representatives of the institutions completed a questionnaire based on acts to promote and support breastfeeding, the Baby-Friendly Hospital Initiative, and Brazil's federal law recommendations. RESULTS: The results showed that in delivery rooms, 98.5% of the services prohibited immediate and uninterrupted skin-to-skin contact between mothers and their infants and did not support mothers to initiate breastfeeding in the first hour. On the postnatal ward, 98.5% of the services allowed breastfeeding while implementing respiratory hygiene practices to prevent transmission of COVID-19. Companions for mothers were forbidden in 83.3% of the hospitals. Hospital discharge was mostly between 24 and 28 h (79.1%); discharge guidelines were not individualized. Additionally, a lack of support was noticed from the home environment's health community network (83.3%). Hospital and home breast pumping were allowed (87.5%), but breast milk donation was not accepted (95.8%). There was a lack of guidance regarding the use of infant comforting strategies. Guidelines specific for vulnerable populations were not covered in the material evaluated. CONCLUSIONS: In Brazil, hospitals have not followed recommendations to protect, promote, and support breastfeeding during the COVID-19 outbreak. The disagreement between international guidelines has been a major issue. The absence of recommendations on breastfeeding support during the pandemic led to difficulties in developing standards among hospitals in different regions of Brazil and other countries worldwide. The scientific community needs to discuss how to improve maternal and infant care services to protect breastfeeding in the current pandemic.


Asunto(s)
Lactancia Materna , Adhesión a Directriz , Higiene , Brasil/epidemiología , Lactancia Materna/efectos adversos , /etiología , Estudios Transversales , Brotes de Enfermedades/prevención & control , Femenino , Adhesión a Directriz/estadística & datos numéricos , Hospitales , Humanos , Servicios de Salud Materna , Pandemias , Embarazo , Encuestas y Cuestionarios
5.
BMC Surg ; 21(1): 180, 2021 Apr 06.
Artículo en Inglés | MEDLINE | ID: mdl-33823831

RESUMEN

BACKGROUND: COVID-19 pandemic has impacted the Italian National Health Care system at many different levels, causing a complete reorganization of surgical wards. In this context, our study retrospectively analysed the management strategy for patients with acute cholecystitis. METHODS: We analysed all patients admitted to our Emergency Department for acute cholecystitis between February and April 2020 and we graded each case according to 2018 Tokyo Guidelines. All patients were tested for positivity to SARS-CoV-2 and received an initial conservative treatment. We focused on patients submitted to cholecystostomy during the acute phase of pandemic and their subsequent disease evolution. RESULTS: Thirty-seven patients were admitted for acute cholecystitis (13 grade I, 16 grade II, 8 grade III). According to Tokyo Guidelines (2018), patients were successfully treated with antibiotic only, bedside percutaneous transhepatic gallbladder drainage (PC) and laparoscopic cholecystectomy (LC) in 29.7%, 21.6% and 48.7% of cases respectively. Therapeutic strategy of three out of 8 cases, otherwise fit for surgery, submitted to bedside percutaneous transhepatic gallbladder drainage (37.5%), were directly modified by COVID-19 pandemic: one due to the SARS-CoV-2 positivity, while two others due to unavailability of operating room and intensive care unit for post-operative monitoring respectively. Overall success rate of percutaneous cholecystostomy was of 87.5%. The mean post-procedural hospitalization length was 9 days, and no related adverse events were observed apart from transient parietal bleeding, conservatively treated. Once discharged, two patients required readmission because of acute biliary symptoms. Median time of drainage removal was 43 days and only 50% patients thereafter underwent cholecystectomy. CONCLUSIONS: Percutaneous cholecystostomy has shown to be an effective and safe treatment thus acquiring an increased relevance in the first phase of the pandemic. Nowadays, considering we are forced to live with the SARS-CoV-2 virus, PC should be considered as a virtuous, alternative tool for potentially all COVID-19 positive patients and selectively for negative cases unresponsive to conservative therapy and unfit for surgery.


Asunto(s)
Colecistitis Aguda , Brotes de Enfermedades , /epidemiología , Colecistitis Aguda/cirugía , Colecistostomía , Hospitales , Humanos , Italia/epidemiología , Estudios Retrospectivos , Resultado del Tratamiento
6.
Angiol Sosud Khir ; 27(1): 143-150, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33825741

RESUMEN

BACKGROUND: According to a series of studies, performing coronary endarterectomy in direct myocardial revascularization increases the risk of myocardial infarction and in-hospital mortality. There are no commonly accepted indications for carrying out endarterectomy, and in clinical practice this technique is used in severe diffuse lesions of coronary arteries. AIM: The study was aimed at assessing in-hospital clinical outcomes of coronary artery bypass grafting (CABG) with the use of endarterectomy in patients with severe multiple diffuse lesions of coronary arteries. PATIENTS AND METHODS: This was a single-centre retrospective study enrolling a total of 205 patients presenting with multiple diffuse lesions and subjected to CABG procedures. Of these, after excluding those with severe concomitant pathology (n=28), 177 were enrolled and divided into 2 groups: 76 patients during formation of a coronary anastomosis were subjected to forced endarterectomy from the native channel (Group 1, n=76) and the remaining patients to prolonged anastomosis and/or bypass grafting of distal branches of the diffusely damaged artery (Group 2, n=101). In-hospital outcomes were analysed in both groups. RESULTS: The demographic and clinical characteristics were comparable by all parameters except for age: Group 1 patients were older (66.3±8.4 vs 63.0±8.5, p<0.05). The groups were comparable by severity of coronary lesions by both the SYNTAX Score and diffuse lesion index. The incidence of perioperative myocardial infarction during coronary endarterectomy (Group 1) amounted to 9.2% (7/71) and in the group without endarterectomy (Group 2) to 0. There were no cases of in-hospital mortality in either group. CONCLUSION: In severe diffuse coronary lesions, endarterectomy combined with CABG makes it possible to perform adequate myocardial revascularization. Performing endarterectomy from coronary arteries is associated with an increased risk for the development of myocardial infarction, but its use is justified if it is impossible to create an anastomosis by means of other techniques.


Asunto(s)
Enfermedad de la Arteria Coronaria , Vasos Coronarios , Puente de Arteria Coronaria/efectos adversos , Enfermedad de la Arteria Coronaria/diagnóstico , Enfermedad de la Arteria Coronaria/cirugía , Vasos Coronarios/diagnóstico por imagen , Vasos Coronarios/cirugía , Endarterectomía/efectos adversos , Hospitales , Humanos , Estudios Retrospectivos , Resultado del Tratamiento
7.
Angiol Sosud Khir ; 27(1): 151-157, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33825742

RESUMEN

AIM: To assess in-hospital outcomes of coronary artery bypass grafting in patients with acute coronary syndrome, depending on the presence or absence of myocardial infarction. PATIENTS AND METHODS: Over the period from 2017 to 2018 within the framework of a single-centre register, the study enrolled a total of 166 consecutive patients admitted with non-ST segment elevation acute coronary syndrome and subjected to coronary artery bypass grafting. Depending on the outcome of acute coronary syndrome, the patients were divided into 2 groups: Group One included 98 (59%) patients with unstable angina pectoris and Group Two comprised 68 (41%) patients with myocardial infarction, who underwent surgery at an average of 16 (11; 20) days after manifestation of the clinical signs of myocardial infarction. The endpoints of the study were major adverse cardiovascular events during the in-hospital period: death, myocardial infarction, acute cerebral circulation impairment/transitory ischaemic attack, repeat revascularization, septic complications, multiple organ failure syndrome, wound infectious complications, requirement for repeated surgical debridement, remediastinotomy due to haemorrhage, the frequency of extracorporeal membrane oxygenation and renal replacement therapy. RESULTS: The mortality rate in the compared groups was similar: 3% (n=3) and 3% (n=2), respectively. Perioperative myocardial infarction occurred in 1 (1%) patient of the first group, with no cases of this complication observed in the second group. The frequency of reoperations due to haemorrhage in the early postoperative period in the group of unstable angina pectoris amounted to 3% (n=3) and was associated with administration of dual antithrombotic therapy, with no cases of this complication in the group of myocardial infarction. Wound complication in the second group were observed in 7.6% (n=5) and in the first group in 4% (n=4) (p=0.33). The differences turned out to be statistically insignificant for such postoperative complications as multiple organ failure syndrome, requirement for repeated surgical debridement, renal replacement therapy, and extracorporeal membrane oxygenation. The residual SYNTAX Score in the group of myocardial infarction amounted to 2.3±2.8, whereas in the group of unstable angina pectoris to 2.3±3, thus suggesting complete revascularization in the total sample of patients with acute coronary syndrome. The average length of hospital stay (including the postoperative period) in the first group amounted to 26.3±6.6 days and in the second group to 27.4±7.2 days (p=0.53). The postoperative bed-day in the group with unstable angina pectoris was 12.6±3.2 and in the myocardial infarction group - 14.9±5.3 (p=0.06). CONCLUSION: The obtained in-hospital outcomes suggest that coronary artery bypass grafting may be an efficient and safe method of complete revascularization for patients with non-ST-elevation acute coronary syndrome, including that resulting in myocardial infarction, performed averagely on day 16 (11; 20) after the onset of clinical manifestations of myocardial infarction.


Asunto(s)
Síndrome Coronario Agudo , Infarto del Miocardio , Angina Inestable/complicaciones , Angina Inestable/diagnóstico , Puente de Arteria Coronaria/efectos adversos , Hospitales , Humanos , Infarto del Miocardio/complicaciones , Infarto del Miocardio/diagnóstico
8.
Artículo en Inglés | MEDLINE | ID: mdl-33800721

RESUMEN

Healthcare workers are at the forefront against COVID-19, worldwide. Since Fondazione Policlinico Universitario A. Gemelli (FPG) IRCCS was enlisted as a COVID-19 hospital, the healthcare workers deployed to COVID-19 wards were separated from those with limited/no exposure, whereas the administrative staff were designated to work from home. Between 4 June and 3 July 2020, an investigation was conducted to evaluate the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin (IgG) antibodies among the employees of the FPG using point-of-care (POC) and venous blood tests. Sensitivity, specificity, and predictive values were determined with reverse-transcription polymerase chain reaction on nasal/oropharyngeal swabs as the diagnostic gold standard. The participants enrolled amounted to 4777. Seroprevalence was 3.66% using the POC test and 1.19% using the venous blood test, with a significant difference (p < 0.05). The POC test sensitivity and specificity were, respectively, 63.64% (95% confidence interval (CI): 62.20% to 65.04%) and 96.64% (95% CI: 96.05% to 97.13%), while those of the venous blood test were, respectively, 78.79% (95% CI: 77.58% to 79.94%) and 99.36% (95% CI: 99.07% to 99.55%). Among the low-risk populations, the POC test's predictive values were 58.33% (positive) and 98.23% (negative), whereas those of the venous blood test were 92.86% (positive) and 98.53% (negative). According to our study, these serological tests cannot be a valid alternative to diagnose COVID-19 infection in progress.


Asunto(s)
Anticuerpos Antivirales , Personal de Salud , Hospitales , Humanos , Roma , Estudios Seroepidemiológicos , Pruebas Serológicas
9.
Artículo en Inglés | MEDLINE | ID: mdl-33801650

RESUMEN

Worldwide, the COVID-19 pandemic has caused a decline in blood donations, between 30% and 70% in some of the most affected countries. In Spain, during the initial eight weeks after the State of Emergency was decreed on 14 March 2020, in the weekly reports of the Health Ministry, an average decrease of 20% was observed between 11 and week 25 compared with the 2018 donation. We aimed to investigate the impact of the COVID-19 pandemic on blood donations and blood distribution in four autonomous communities, and to explore the evolution of the consumption of blood components (BCs) in ten hospitals of six autonomous communities. We performed a prospective study of grouped cohorts on the donation and distribution of blood in four regional transfusion centers in four autonomous communities in Spain, and a retrospective study of the consumption of blood components in ten hospitals in six autonomous communities. Regarding donations, there was no significant decrease in donations, with differences between autonomous communities, which started between 1 and 15 March 2020 (-11%). The increase in donations in phase II (from 26 May 2020) stands out. Regarding consumption, there was a significant reduction in the consumption of packed red blood cells (RBCs) (24.5%), plasma (45.3%), and platelets (25.3%) in the central period (16 March-10 May). The reduction in the consumption of RBCs was significant in the period from 1-15 March. Conclusions: The COVID-19 pandemic has affected the donation and consumption of BCs.


Asunto(s)
Pandemias , Donantes de Sangre , Hospitales , Humanos , Estudios Prospectivos , Estudios Retrospectivos , España/epidemiología
10.
Artículo en Inglés | MEDLINE | ID: mdl-33801759

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic poses a worldwide healthcare challenge that needs an efficient response. Unfortunately, to date there is no highly effective treatment, so a deep understanding of COVID-19 risk factors could be an important step in treating the disease. Vitamin D affects the immune system in many different ways, and other authors already found that COVID-19 patients have low levels of vitamin D. In our retrospective study, we evaluated the vitamin D status at the time of hospital admission in 50 COVID-19 patients in Sicily, which is the southernmost region of Italy, and compared them with 100 control subjects matched for age and sex. Our data showed markedly low levels of vitamin D in patients with a positive polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but no association was found with inflammation markers or clinical severity. Vitamin D levels were reduced at the time of hospital admission in Sicilian SARS-CoV-2-positive patients, but it is not clear whether this condition has an impact on the clinical course of COVID-19.


Asunto(s)
Hospitales , Humanos , Estudios Retrospectivos , Sicilia/epidemiología , Vitamina D
11.
Artículo en Inglés | MEDLINE | ID: mdl-33804893

RESUMEN

BACKGROUND: Healthcare workers (HCWs) have been the key players in the fight against the coronavirus disease 2019 (COVID-19) pandemic. The aim of our study was to evaluate the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) IgG anti-bodies. METHODS: We conducted a cross-sectional study among workers of two hospitals and Territorial Medical and Administrative services in Northern Italy. From 8 May to 3 June 2020, 2252 subjects were tested. Seroprevalence and 95% confidence interval (CI) were calculated for all individuals who were stratified by job title, COVID-19 risk of exposure, direct contact with patients, unit ward, and intensity of care. RESULTS: Median age was 50 years, and 72% of subjects were female. The overall seroprevalence was 17.11% [95% CI 15.55-18.67]. Around 20% of healthcare assistants were seropositive, followed by physicians and nurses (16.89% and 15.84%, respectively). HCWs with high risk of exposure to COVID-19 were more frequently seropositive (28.52%) with respect to those with medium and low risks (16.71% and 12.76%, respectively). Moreover, personnel in direct contact had higher prevalence (18.32%) compared to those who did not (10.66%). Furthermore, the IgG were more frequently detected among personnel of one hospital (19.43%). CONCLUSION: The high seroprevalence observed can be partially explained by the timing and the population seroprevalence; the study was conducted in an area with huge spread of the infection.


Asunto(s)
Anticuerpos Antivirales , Estudios Transversales , Femenino , Personal de Salud , Hospitales , Humanos , Italia/epidemiología , Persona de Mediana Edad , Estudios Seroepidemiológicos
12.
Artículo en Inglés | MEDLINE | ID: mdl-33809277

RESUMEN

COVID-19 can cause important sequels in the respiratory system and frequently presents loss of strength, dyspnea, polyneuropathies and multi-organic affectation. Physiotherapy interventions acquire a fundamental role in the recovery of the functions and the quality of life. Regarding the recovery phases after hospital discharge, the current evidence available is very preliminary. Telerehabilitation is presented as a promising complementary treatment method to standard physiotherapy. The main objective of this research is to evaluate the effectiveness of a personalized telerehabilitation intervention after discharge from hospital for the improvement of functional capacity and quality of life compared to a program of health education and/or care in a rehabilitation center. As secondary objectives, to identify the satisfaction and perception of patients with the telerehabilitation intervention and the presence of barriers to its implementation, as well as to evaluate the cost-effectiveness from the perspective of the health system. This study protocol will be carried out through a single blind multicenter randomized clinical trial in the south of Spain. We hypothesize that the implementation of a telerehabilitation program presents results not inferior to those obtained with the current standard intervention. If the hypothesis is confirmed, it would be an opportunity to define new policies and interventions to address this disease and its consequences. Trial registration NCT04742946.


Asunto(s)
Telerrehabilitación , Hospitales , Humanos , Estudios Multicéntricos como Asunto , Calidad de Vida , Ensayos Clínicos Controlados Aleatorios como Asunto , Método Simple Ciego , España , Resultado del Tratamiento
13.
Artículo en Inglés | MEDLINE | ID: mdl-33810004

RESUMEN

The COVID-19 pandemic has had an emotional impact on healthcare professionals at different levels of care, and it is important to understand the levels of anxiety of hospital personnel (HP) compared to those of primary care personnel (PCP). The objectives herein were to assess the differences in anxiety levels between these populations and to detect factors that may influence them. The anxiety levels (measured using the Hospital Anxiety and Depression (HAD) scale) of the HP and PCP groups were compared using data collected from a cross-sectional study. The secondary variables included demographic and health data, confinement factors, contact with COVID-19 patients, having suffered from COVID-19, perceptions of protection, caregiver overload, threat, and satisfaction with management. We found anxiety "case" (35.6%) and "at-risk" (21%), with statistically significant differences in the group "at risk", and higher scores in the PCP group. The factors associated with the perception of threat and protection were significant determinants of an increase in anxiety, with all of them showing statistically significant differences. There were greater symptoms of anxiety in the PCP group than the HP group (32% vs. 18%). The factors associated with the prevalence of anxiety symptoms were the perceptions of threat, protection, management, caregiver overload, and perceived degree of threat associated with COVID-19.


Asunto(s)
Pandemias , Ansiedad/epidemiología , Estudios Transversales , Prestación de Atención de Salud , Depresión/epidemiología , Personal de Salud , Hospitales , Humanos , Atención Primaria de Salud
14.
Artículo en Inglés | MEDLINE | ID: mdl-33810438

RESUMEN

(1) Background: The implementation of effective control measures in a timely fashion is crucial to control the epidemic outbreak of COVID-19. In this study, we aimed to analyze the control measures implemented during the COVID-19 outbreak, as well as evaluating the responses and outcomes at different phases for epidemic control in Taiwan. (2) Methods: This case study reviewed responses to COVID-19 and the effectiveness of a range of control measures implemented for epidemic control in Taiwan and assessed all laboratory-confirmed cases between 11 January until 20 December 2020, inclusive of these dates. The confirmation of COVID-19 infection was defined as the positive result of a reverse-transcriptase-polymerase-chain-reaction test taken from a nasopharyngeal swab. Test results were reported by the Taiwan Centers for Disease Control. The incidence rate, mortality rate, and testing rate were compiled, and the risk ratio was provided to gain insights into the effectiveness of prevention measures. (3) Results and Discussion: This study presents retrospective data on the COVID-19 incidence rate in Taiwan, combined with the vital preventive control measures, in a timeline of the early stage of the epidemic that occurred in Taiwan. The implementation of multiple strategy control measures and the assistance of technologies to control the COVID-19 epidemic in Taiwan led to a relatively slower trend in the outbreak compared to the neighboring countries. In Taiwan, 766 confirmed patients were included, comprised of 88.1% imported cases and 7.2% local transmission cases, within the studied period. The incidence rate of COVID-19 in Taiwan during the studied period was 32 per million people, with a mortality rate of 0.3 per million people. Our analysis showed a significantly raised incidence risk ratio in the countries of interest in comparison to Taiwan during the study period; in the range of 1.9 to 947.5. The outbreak was brought under control through epidemic policies and hospital strategies implemented by the Taiwan Government. (4) Conclusion: Taiwan's preventive strategies resulted in a drastically lower risk for Taiwan nationals of contracting COVID-19 when new pharmaceutical drug or vaccines were not yet available. The preventive strategies employed by Taiwan could serve as a guide and reference for future epidemic control strategies.


Asunto(s)
Epidemias , Brotes de Enfermedades , Hospitales , Humanos , Políticas , Estudios Retrospectivos , Taiwán/epidemiología
15.
Medicine (Baltimore) ; 100(9): e24956, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655962

RESUMEN

INTRODUCTION: Due to the diversity of reports and on the rates of medications errors (MEs) in Saudi Arabia, we performed the first meta-analysis to determine the rate of medications errors in Saudi Arabia using meta-analysis in the hospital settings. METHODS: We conducted a systematic literature search through August 2019 using PubMed, EMBASE, CINAHL, PsycINFO, and Google Scholar to identify all observational studies conducted in hospital settings in Saudi Arabia that reported the rate of MEs. A random-effects models were used to calculate overall MEs, as well as prescribing, dispensing, and administration error rates. The I2 statistics were used to analyze heterogeneity. RESULTS: Sixteen articles were included in this search. The total incidence of MEs in Saudi Arabia hospitals was estimated at 44.4%. Prescribing errors, dispensing errors, and adminstration errors incidents represent 40.2%, 28.2%, and 34.5% out of the total number of reported MEs, respectively. However, between-study heterogeneity was also generally found to be >90% (I-squared statistic). CONCLUSIONS: This study demonstrates the MEs common in health facilities. Additional efforts in the field are needed to improve medication management systems in order to prevent patient harm incidents.


Asunto(s)
Hospitales/estadística & datos numéricos , Errores de Medicación/estadística & datos numéricos , Humanos , Incidencia , Arabia Saudita/epidemiología
16.
PLoS One ; 16(3): e0247865, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33657142

RESUMEN

COVID-19 is a global threat with an increasing number of infections. Research on IgG seroprevalence among health care workers (HCWs) is needed to re-evaluate health policies. This study was performed in three pandemic hospitals in Istanbul and Kocaeli. Different clusters of HCWs were screened for SARS-CoV-2 infection. Seropositivity rate among participants was evaluated by chemiluminescent microparticle immunoassay. We recruited 813 non-infected and 119 PCR-confirmed infected HCWs. Of the previously undiagnosed HCWs, 22 (2.7%) were seropositive. Seropositivity rates were highest for cleaning staff (6%), physicians (4%), nurses (2.2%) and radiology technicians (1%). Non-pandemic clinic (6.4%) and ICU (4.3%) had the highest prevalence. HCWs in "high risk" group had similar seropositivity rate with "no risk" group (2.9 vs 3.5 p = 0.7). These findings might lead to the re-evaluation of infection control and transmission dynamics in hospitals.


Asunto(s)
/epidemiología , Personal de Salud/tendencias , /inmunología , /inmunología , Hospitales/tendencias , Humanos , Control de Infecciones/métodos , Control de Infecciones/tendencias , Pandemias , Prevalencia , Factores de Riesgo , Estudios Seroepidemiológicos , Turquia/epidemiología
17.
PLoS One ; 16(3): e0247463, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33657621

RESUMEN

The risk of overwhelming hospitals from multiple waves of COVID-19 is yet to be quantified. Here, we investigate the impact of different scenarios of releasing strong measures implemented around the U.S. on COVID-19 hospitalized cases and the risk of overwhelming the hospitals while considering resources at the county level. We show that multiple waves might cause an unprecedented impact on the hospitals if an increasing number of the population becomes susceptible and/or if the various protective measures are discontinued. Furthermore, we explore the ability of different mitigation strategies in providing considerable relief to hospitals. The results can help planners, policymakers, and state officials decide on additional resources required and when to return to normalcy.


Asunto(s)
/epidemiología , Política de Salud/tendencias , Hospitalización/tendencias , Prestación de Atención de Salud/tendencias , Instituciones de Salud/tendencias , Hospitalización/estadística & datos numéricos , Hospitales/tendencias , Humanos , Modelos Estadísticos , Pandemias/estadística & datos numéricos , Estados Unidos/epidemiología
18.
Artículo en Chino | MEDLINE | ID: mdl-33781034

RESUMEN

Objective: To explore the effect of failure mode and effect analysis (FMEA) in the management of nosocomial infection, and provide reference for the effective prevention and control of nosocomial infection. Methods: Using FMEA to identify, analyze, evaluate and screen out the high-risk events of nosocomial infection in January 2020, from which two hospital level priority improvement projects of hand hygiene compliance and blood-borne occupational exposure were determined. After risk control and intervention measures, the effects before and after improvement were compared. Results: Except for the lack of incentive mechanism and insufficient communication between medical and nursing teams, the differences in hand hygiene compliance and blood-borne occupational exposure risk priority coefficients before and after the implementation of FMEA were statistically significant (P<0.05) . After the implementation of FMEA, the hand hygiene compliance was 74.92% (79375/105953) , which was significantly higher than 68.40% (58361/85328) before the implementation of FMEA, and the difference was statistically significant (χ(2)=996.55, P<0.01) . The incidence of blood-borne occupational exposure after the implementation of FMEA was 3.85% (80/2080) , which was lower than the 6.16% (123/1998) before the implementation of FMEA, and the difference was statistically significant (χ(2)=11.49, P<0.01) . Conclusion: FMEA has a good effect in nosocomial infection management. It can identify and evaluate the risk of nosocomial infection prospectively, so as to control the risk effectively.


Asunto(s)
Infección Hospitalaria , Higiene de las Manos , Análisis de Modo y Efecto de Fallas en la Atención de la Salud , Infección Hospitalaria/prevención & control , Hospitales , Humanos
19.
Artículo en Chino | MEDLINE | ID: mdl-33781039

RESUMEN

Objective: To investigate the status quo of operating room nurse career management in Shandong Province, and to analysis its influencing factors. Methods: In February 2019, 1418 operating room nurses in Shandong province were selected to investigate their general situation and current status of career management and analyze possible influencing factors by using the General Information Questionnaire, the Career Management Questionnaire for Nurses and the Career Planning Questionnaire for Nurses. Results: The total score of organizational career management scale was (48.24±11.12) points, with the score of dimension from high to low as valueing training (12.64±2.54) points, justice in promotion (12.11±3.04) points, providing career information (12.10±3.21) points, promotion in career self-development (11.39±3.46) points. The total score of organizational career planning scale was (43.33±9.00) points. Multiple liner regression analysis showed that career planning (ß=0.742, P<0.001) , hospital grade (ß=-0.068, P<0.001) and age (ß=-0.065, P<0.001) were influencing factors of operating room nurse career management which could explained 57.1% of the variation (F=630.596, P<0.001) . Conclusion: Career management of operating room nurse is at a medium level, the scores of different dimensions are not balanced.Career planning score, hospital level, age and other factors affect the career management score of operating room nurses.


Asunto(s)
Hospitales , Quirófanos , Estudios Transversales , Humanos , Encuestas y Cuestionarios
20.
New Microbiol ; 44(1): 51-58, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33755185

RESUMEN

This paper aims to describe the etiology of bloodstream infections in COVID-19, Papa Giovanni XXIII Hospital, Bergamo, Italy. Two periods were evaluated: February 22-May 21, 2019/2020. We considered: the number of patients and blood culture sets, species of isolates (bacteria, specifically those indicated by EARS criteria; CoNS; Candida albicans) and their antibiotic sensitivity. In 2020 Escherichia coli and Carbapenemase-producing Klebsiella pneumoniae disappeared. Candida albicans and MDR Pseudomonas aeruginosa, Enterococcus faecium and Acinetobacter baumannii were largely present. The analysis shows: 1. BSIs number was the same; 2. In the first month of the COVID-19 period, BSIs were uncommon; 3. Microbial etiologies were different; 4. MDR isolates were less common.


Asunto(s)
Sepsis , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Hospitales , Humanos , Italia , Pruebas de Sensibilidad Microbiana , Estudios Retrospectivos , Sepsis/tratamiento farmacológico
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