Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 38.797
Filtrar
1.
Rev. bioét. derecho ; (50): 189-203, nov. 2020.
Artículo en Español | IBECS | ID: ibc-191353

RESUMEN

La actual pandemia por la COVID-19 está ocasionado serias amenazas para la salud pública a nivel mundial, especialmente para los grupos de población más vulnerables. Los casos más graves de la enfermedad han sido primeramente atendidos por los profesionales de urgencias y emergencias, los cuales han tenido que tomar decisiones en contextos altamente complejos donde la priorización en la asignación de los recursos sanitarios disponibles les ha generado situaciones éticamente conflictivas. El objetivo del presente artículo es analizar la importancia de implantar la PDA en los servicios de urgencias y emergencias como herramienta de consulta en la resolución de los problemas éticos surgidos durante la pandemia por COVID-19, concretamente, en la atención al paciente crónico complejo o con enfermedad crónica avanzada


The events of the present CoVID-19 pandemic are causing serious threats to Public Health worldwide, specifically at the most vulnerable population groups. Emergency professionals have served as the first responders for the most serious cases of this disease. At the same time, they have made decisions in highly complex contexts where the prioritization of allocated care resources has generated ethically conflictive situations. The aim of this article is to analyze the importance of implementing the ACP as a tool in the emergency services to solve ethical problems that have arisen during the COVID-19 pandemic, particularly in the care of complex chronic patients or those with advanced chronic disease


L'actual pandèmia per la COVID-19 està ocasionat serioses amenaces a la salut pública a nivell mundial, especialment als grups de població més vulnerables. Els casos més greus de la malaltia han estat primerament atesos pels professionals d'urgències I emergències, els quals han hagut de prendre decisions en contextos altament complexos on la priorització en l'assignació dels recursos sanitaris disponibles els ha generat situacions èticament conflictives. L'objectiu d'aquest article va ser analitzar la importància d'implantar la PDA en els serveis d'urgències I emergències com a eina de consulta a la resolució dels problemes ètics sorgits durant la pandèmia per COVID-19, concretament, en l'atenció al pacient crònic complex o amb malaltia crònica avançada


Asunto(s)
Humanos , Prioridades en Salud/ética , Prioridades en Salud/organización & administración , Planificación de Atención al Paciente , Toma de Decisiones/ética , Conflicto de Intereses , Servicios Médicos de Urgencia/ética , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pandemias , Enfermedad Crónica
2.
Ital J Pediatr ; 46(1): 142, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33008445

RESUMEN

BACKGROUND: The coronavirus disease 2019 (COVID-19) is currently rare in children and they seem to have a milder disease course and better prognosis than adults. However, SARS-Cov-2 pandemic has indirectly caused problems in pediatric medical assistance. In view of this we wanted to draw a picture of what happened during health emergency and analyze future prospects for restarting. METHODS: We involved the Italian pediatric scientific societies institutionally collected in the Italian Federation of Associations and Scientific Societies of the Pediatric Area (FIARPED); We sent a questionnaire to all scientific societies about the pediatric care activity during the COVID-19 emergency and future perspectives for the phase of post-containment. RESULTS: The analysis of the questionnaires showed significant decrease of:admission, outpatient visits and specialist consultancy activities during the COVID-19 emergency, primarily linked to the fear of infection. Instead it was increased the serious degree of diseases admitted. Most of scientific societies maintained the relationship with chronic patients through some form of telemedicine, reporting a strong positive opinion about this modality. Finally showed the need to give life a new approach for hospitalizations and outpatient visits through a greater use of telemedicine, educational programs on families and a more decisive role of family pediatricians. CONCLUSIONS: Our study highlighted many aspects that can be improved in pediatric care. We think that It will be necessary a new shared strategy to improve the management and continuity of care for pediatric patients, primarily developing a network of collaboration between families, family pediatrician and hospitals and by enhancing the use of new methods of telecommunications.


Asunto(s)
Infecciones por Coronavirus/prevención & control , Control de Infecciones/organización & administración , Pandemias/prevención & control , Neumonía Viral/prevención & control , Cuarentena/organización & administración , Encuestas y Cuestionarios , Telemedicina/estadística & datos numéricos , Adulto , Atención Ambulatoria/estadística & datos numéricos , Niño , Infecciones por Coronavirus/epidemiología , Prestación de Atención de Salud/organización & administración , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Italia , Masculino , Evaluación de Resultado en la Atención de Salud , Pandemias/estadística & datos numéricos , Planificación de Atención al Paciente/organización & administración , Pediatría/métodos , Neumonía Viral/epidemiología , Sociedades Médicas
4.
Prim Dent J ; 9(3): 23-28, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32940593

RESUMEN

With patients living longer and retaining their natural teeth for longer, dental healthcare professionals are presented with new challenges. This paper outlines considerations for dental health care professionals managing periodontal disease in an ageing population. Although age itself is not considered an independent risk factor for periodontal disease, there may be complicating factors associated with ageing that impact upon the planning and delivery of care. This paper describes current evidence for the management of periodontal disease in the context of health conditions associated with ageing. It identifies aspects to consider and provides advice on how treatment planning for this patient population may be tailored.


Asunto(s)
Enfermedades Periodontales , Envejecimiento , Humanos , Planificación de Atención al Paciente , Factores de Riesgo
5.
Oral Maxillofac Surg Clin North Am ; 32(4): 519-559, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32919832

RESUMEN

Impacted third molars occur in a significant number of patients and often require treatment because of presence of symptoms and/or disease. Management of these teeth typically involves referral to oral and maxillofacial surgeons for diagnosis, treatment planning, and ultimate removal if indicated. Proper diagnosis and treatment planning helps optimize surgical results at each stage of the procedure, and ultimately patient outcomes. Adherence to proper surgical techniques helps minimize risks and complications associated with the procedure. Multiple alternative surgical techniques also exist for uncommon, but potentially complicated, situations that arise with some impacted third molars.


Asunto(s)
Tercer Molar/cirugía , Diente Impactado/cirugía , Humanos , Planificación de Atención al Paciente , Derivación y Consulta , Extracción Dental
7.
Brasília, D.F.; OPAS; 2020-09-08. (OPAS-W/BRA/COVID-19/20-107).
No convencional en Portugués | PAHO-IRIS | ID: phr2-52643

RESUMEN

A pandemia da COVID-19 afetou desproporcionalmente os idosos, principalmente aqueles que vivem em instituições de longa permanência. Em muitos países, as evidências mostram que mais de 40% das mortes relacionadas à COVID-19 foram ligadas a instituições de longa permanência, chegando a 80% em alguns países de alta renda. Além disso, nas instituições de longa permanência, a taxa de letalidade de residentes com COVID-19 pode ser maior do que na população da mesma idade que vive fora de instituições de longa permanência. Os residentes de instituições de longa permanência frequentemente enfrentam alto risco, baixas medidas preventivas e recursos inadequados para se recuperar da COVID-19, bem como acesso reduzido a serviços essenciais de saúde em um contexto no qual os sistemas de saúde se deparam com restrições durante o surto da COVID-19... Este sumário de políticas fornece 11 objetivos e pontos de ação importantes para prevenir e gerenciar a COVID-19 na assistência de longa permanência. Seu público-alvo é formado por legisladores e autoridades (nacionais, subnacionais e locais) envolvidos na pandemia da COVID-19. O sumário se baseia em evidências atualmente disponíveis referentes a medidas adotadas para prevenção, preparação e resposta à pandemia da COVID-19 e para mitigar seu impacto nos serviços de assistência de longa permanência, incluindo os prestadores de cuidados. Embora este documento contenha opções de políticas e ações relevantes para todos os ambientes de assistência de longa permanência, as instituições de longa permanência são enfatizadas porque apresentaram incidência, morbidade e mortalidade extremamente altas referentes à COVID-19.


Asunto(s)
Infecciones por Coronavirus , Pandemias , Betacoronavirus , Servicios de Salud , Tiempo de Internación , Planificación de Atención al Paciente
8.
Enferm. foco (Brasília) ; 11(1,n.esp): 235-238, ago. 2020. ilus
Artículo en Portugués | LILACS, BDENF - Enfermería | ID: biblio-1116874

RESUMEN

Objetivo: descrever as principais medidas tomadas para mudança dos processos assistenciais e de comunicação interna na vigência da pandemia por COVID-19 de um hospital oncológico. Método: Trata-se de um relato de experiência. Resultados: 1) Criação do fórum para tomadas de decisões assistenciais. 2) Criação do canal de dúvidas e centralização dos protocolos assistenciais e 3) Encontro semanais online. Considerações finais: O êxito e as conquista obtidas até o momento, se dão o trabalho em equipe, o alinhamento com uma linguagem única e a busca pelo os princípios guiados pela segurança do paciente, dos profissionais, acesso e qualidade da informação, através da busca de uma comunicação efetiva. (AU)


Objective: to describe the main measures adopted to change the care and internal communication processes in the pandemic surveillance by COVID-19 of an oncology hospital. Method: This is an experience report. Results: 1) Creation of a forum for assistance decision-making. 2) Creation of the channel of doubts and centralization of assistance protocols and 3) Weekly online meeting. Final considerations: Success and achievement so far, if the work is carried out as a team, alignment with a unique language and the search for principles guided by the safety of the patient, professionals, access and quality of information, by seeking effective communication. (AU)


Objetivo: describir las principales medidas tomadas para cambiar los procesos de atención y comunicación interna durante la pandemia COVID-19 de un hospital oncológico. Método: este es un informe de experiencia. Resultados: 1) Creación de un foro para la toma de decisiones de asistencia. 2) Creación del canal de dudas y centralización de protocolos de asistencia y 3) Reunión semanal en línea. Consideraciones finales: El éxito y los logros alcanzados hasta ahora se deben al trabajo en equipo, la alineación con un lenguaje único y la búsqueda de principios guiados por la seguridad del paciente, los profesionales, el acceso y la calidad de la información, a través de la búsqueda. comunicación efectiva. (AU)


Asunto(s)
Planificación de Atención al Paciente , Enfermería , Infecciones por Coronavirus , Gestión de la Práctica Profesional
13.
J Emerg Manag ; 18(4): 281-293, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32804397

RESUMEN

OBJECTIVE: This case study elaborates on the theme of crisis planning and addresses the question of the value of crisis plans and for whom. METHOD: This study is based on the data collected during a water pollution incident and consists of interviews, notes, and observations at a Municipal Council, County Administrative Board, and County Council in Sweden. RESULT: Merton's concept of manifest and latent function offers a new understanding in the discussion of crisis plans. The result is then related to how known the place, task, and situation are to them. The manifest function im-plies that preparing crisis plans are supposed to direct officials in how to act when a crisis occurs. However, the plan was not made by or intended for the operative personnel who handled the water pollution crisis. Rather, this study shows that the personnel acted on the basis of their professional knowledge and earlier experiences when handling the crisis, and their knowledge can be related to the context of the crisis, and how known the place, task, and situa-tion are to them. CONCLUSION: This research adds to the knowledge of the use of crisis plans. It shows that the importance of having a crisis plan is related to how known the situation and the place is to those handling the crisis, and if the task to be done is known to them. Knowing the place and task helps the personnel to improvise in an unknown situation, and the crisis plan is not used. The value of a crisis plan arises when the task is unknown.


Asunto(s)
Intervención en la Crisis (Psiquiatría) , Planificación en Desastres , Planificación de Atención al Paciente , Humanos
14.
Rev Bras Ginecol Obstet ; 42(7): 415-419, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32736393

RESUMEN

It is estimated that around 28 million surgeries will be postponed or canceled worldwide as a result of this pandemic, causing a delay in the diagnosis and treatment of more than 2 million cancer cases. In Brazil, both the National Health Agency (ANS) and National Health Surveillance Agency (ANVISA) advised the postponement of elective and non-essential surgeries, causing a considerable impact on the number of surgical procedures that decreased by 33.4% in this period. However, some women need treatment for various gynecological diseases that cannot be postponed. The purpose of this article is to present recommendations on surgical treatment during the COVID-19 pandemic.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Procedimientos Quirúrgicos Ginecológicos , Pandemias , Planificación de Atención al Paciente , Neumonía Viral/epidemiología , Betacoronavirus , Brasil/epidemiología , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/transmisión , Infección Hospitalaria/prevención & control , Transmisión de Enfermedad Infecciosa/prevención & control , Procedimientos Quirúrgicos Electivos/estadística & datos numéricos , Femenino , Procedimientos Quirúrgicos Ginecológicos/estadística & datos numéricos , Humanos , Neumonía Viral/diagnóstico , Neumonía Viral/transmisión , Factores de Riesgo
15.
Nat Commun ; 11(1): 4308, 2020 08 27.
Artículo en Inglés | MEDLINE | ID: mdl-32855399

RESUMEN

Distant metastasis (DM) is the main cause of treatment failure in locally advanced rectal cancer. Adjuvant chemotherapy is usually used for distant control. However, not all patients can benefit from adjuvant chemotherapy, and particularly, some patients may even get worse outcomes after the treatment. We develop and validate an MRI-based radiomic signature (RS) for prediction of DM within a multicenter dataset. The RS is proved to be an independent prognostic factor as it not only demonstrates good accuracy for discriminating patients into high and low risk of DM in all the four cohorts, but also outperforms clinical models. Within the stratified analysis, good chemotherapy efficacy is observed for patients with pN2 disease and low RS, whereas poor chemotherapy efficacy is detected in patients with pT1-2 or pN0 disease and high RS. The RS may help individualized treatment planning to select patients who may benefit from adjuvant chemotherapy for distant control.


Asunto(s)
Antineoplásicos/uso terapéutico , Nomogramas , Proctectomía , Neoplasias del Recto/terapia , Recto/diagnóstico por imagen , Adulto , Anciano , Quimioterapia Adyuvante/estadística & datos numéricos , Conjuntos de Datos como Asunto , Supervivencia sin Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Terapia Neoadyuvante/estadística & datos numéricos , Metástasis de la Neoplasia/diagnóstico , Metástasis de la Neoplasia/prevención & control , Estadificación de Neoplasias , Planificación de Atención al Paciente , Selección de Paciente , Radioterapia Ayuvante/estadística & datos numéricos , Neoplasias del Recto/diagnóstico por imagen , Neoplasias del Recto/patología , Recto/patología , Recto/cirugía , Reproducibilidad de los Resultados , Estudios Retrospectivos , Medición de Riesgo/métodos
16.
Med Clin North Am ; 104(5): 767-775, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-32773044

RESUMEN

Goals of care conversations are important but complex for clinicians caring for older adults. Although clinicians tend to focus on specific medical interventions, these conversations are more successful if they begin with gaining a shared understanding of the medical conditions and possible outcomes, followed by discussion of values and goals. Although training in the medical setting is incomplete, there are many published and online resources that can help clinicians gain these valuable skills.


Asunto(s)
Toma de Decisiones Conjunta , Cuidados Paliativos , Planificación de Atención al Paciente , Anciano , Competencia Clínica , Humanos , Cuidados Paliativos/ética , Cuidados Paliativos/métodos , Cuidados Paliativos/psicología , Planificación de Atención al Paciente/ética , Planificación de Atención al Paciente/normas , Relaciones Médico-Paciente
18.
Curr Med Sci ; 40(4): 602-607, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32767261

RESUMEN

This study aims to develop the expert consensus on nurse's human caring for Corona Virus Disease 2019 (COVID-19) patients in different sites, and thus provide a guideline on providing whole process and systematic caring for COVID-19 patients. Based on the frontline experiences of human caring for COVID-19 patients and the review of literature, the initial draft of consensus was made and finalized after online meeting and revisions. The experts reached consensus on the following parts: terms and definitions, principles of human caring for COVID-19 patients, and human caring measures for COVID-19 patients in different sites. The expert consensus is practical, concise, and reasonable for guiding the nurses providing human caring for COVID-19 patients, as well as other similar infectious diseases.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/enfermería , Atención de Enfermería/métodos , Neumonía Viral/enfermería , China/epidemiología , Consenso , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/epidemiología , Testimonio de Experto , Humanos , Pandemias , Planificación de Atención al Paciente , Aislamiento de Pacientes , Neumonía Viral/epidemiología , Pautas de la Práctica en Enfermería , Cuarentena , Enfermería en Rehabilitación
19.
Rozhl Chir ; 99(6): 249-257, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32736479

RESUMEN

Complex anorectal examination including a detailed medical history, physical proctological examination and evaluation of the sensorimotor and structural function of the anorectum is essential for the diagnosis and therapeutic management of functional anorectal dysfunction. The aim of the work is to provide an overview of diagnosing functional anorectal disorders according to the new update and consensus statement of the International Anorectal Physiology Working Group (IAPWG) with a focus on indications, a standardized examination protocol and introduction of the new London classification of anorectal dysfunction. The indications are: fecal incontinence, defecation disorders, functional pelvic (anorectal) pain, evaluation before an anorectal intervention and before planned delivery to assess the function of a previously traumatized anal sphincter. Standardization of the diagnosis and the evaluated data are the basis for multidisciplinary cooperation and determination of a treatment plan for each patient individually.


Asunto(s)
Incontinencia Fecal/diagnóstico , Canal Anal , Defecación , Humanos , Londres , Manometría , Planificación de Atención al Paciente , Recto
20.
Rozhl Chir ; 99(6): 282-288, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32736484

RESUMEN

Presented selected case reports are focused on the individual cases of patients suffering from functional anorectal disorders. During the examination algorithm, the emphasis is on 3D high-resolution anorectal manometry, which is a useful diagnostic technique and helps to understand the pathophysiological mechanisms in the field of functional anorectal disorders. Thanks to a comprehensive examination an individualized treatment plan can be determined for each patient.


Asunto(s)
Incontinencia Fecal , Canal Anal , Estreñimiento , Defecación , Humanos , Manometría , Planificación de Atención al Paciente , Recto
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA