Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.837
Filtrar
2.
Gynecol Oncol ; 160(3): 649-654, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33358197

RESUMEN

BACKGROUND: Surgery is the cornerstone of gynecological cancer management, but inpatient treatment may expose both patients and healthcare staff to COVID-19 infections. Plans to mitigate the impact of the COVID-19 pandemic have been implemented widely, but few studies have evaluated the effectiveness of these plans in maintaining safe surgical care delivery. AIM: To evaluate the effects of mitigating plans implemented on the delivery of gynecological cancer surgery during the COVID-19 pandemic. METHODS: A comparative cohort study of patients treated in a high-volume tertiary gyneoncological centre in the United Kingdom. Prospectively-recorded consecutive operations performed and early peri-operative outcomes during the same calendar periods (January-August) in 2019 and 2020 were compared. RESULTS: In total, 585 operations were performed (296 in 2019; 289 in 2020). There was no significant difference in patient demographics. Types of surgery performed were different (p = 0.034), with fewer cytoreductive surgeries for ovarian cancer and laparoscopic procedures (p = 0.002) in 2020. There was no difference in intra-operative complication rates, critical care admission rates or length of stay. One patient had confirmed COVID-19 infection (0.4%). The 30-day post-operative complication rates were significantly higher in 2020 than in 2019 (58 [20.1%] versus 32 [10.8%]; p = 0.002) for both minor and major complications. This increase, primarily from March 2020 onwards, coincided with the first peak of the COVID-19 pandemic in the UK. CONCLUSIONS: Maintaining surgical throughput with meticulous and timely planning is feasible during the COVID-19 pandemic but this was associated with an increase in post-operative complications due to a multitude of reasons.


Asunto(s)
/prevención & control , Prestación de Atención de Salud/organización & administración , Neoplasias de los Genitales Femeninos/cirugía , Procedimientos Quirúrgicos Ginecológicos/estadística & datos numéricos , Ginecología/organización & administración , Oncología Quirúrgica/organización & administración , Anciano , Estudios de Cohortes , Procedimientos Quirúrgicos de Citorreducción/estadística & datos numéricos , Prestación de Atención de Salud/métodos , Femenino , Ginecología/métodos , Personal de Salud , Humanos , Control de Infecciones/métodos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Complicaciones Intraoperatorias/epidemiología , Laparoscopía/estadística & datos numéricos , Tiempo de Internación/estadística & datos numéricos , Tamizaje Masivo , Persona de Mediana Edad , Servicio de Oncología en Hospital , Equipo de Protección Personal , Complicaciones Posoperatorias/epidemiología , Cuarentena , Medicina Estatal , Oncología Quirúrgica/métodos , Centros de Atención Terciaria , Reino Unido
3.
Front Public Health ; 8: 583583, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33330324

RESUMEN

The SARS-CoV-2 (COVID-19) pandemic led to an emergency scenario within all aspects of health care, determining reduction in resources for the treatment of other diseases. A literature review was conducted to identify published evidence, from 1 March to 1 June 2020, regarding the impact of COVID-19 on the care provided to patients affected by other diseases. The research is limited to the Italian NHS. The aim is to provide a snapshot of the COVID-19 impact on the NHS and collect useful elements to improve Italian response models. Data available for oncology and cardiology are reported. National surveys, retrospective analyses, and single-hospital evidence are available. We summarized evidence, keeping in mind the entire clinical pathway, from clinical need to access to care to outcomes. Since the beginning, the COVID-19 pandemic was associated with a reduced access to inpatient (-48% for IMA) and outpatient services, with a lower volume of elective surgical procedures (in oncology, from 3.8 to 2.6 median number of procedures/week). Telehealth may plays a key role in this, particularly in oncology. While, for cardiology, evidence on health outcome is already available, in terms of increased fatality rates (for STEMI: 13.7 vs. 4.1%). To better understand the impact of COVID-19 on the health of the population, a broader perspective should be taken. Reasons for reduced access to care must be investigated. Patients fears, misleading communication campaigns, re-arranged clinical pathways could had played a role. In addition, impact on other the status of other patients should be mitigated.


Asunto(s)
Atención Ambulatoria/estadística & datos numéricos , Servicio de Cardiología en Hospital/estadística & datos numéricos , Prestación de Atención de Salud/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Servicio de Oncología en Hospital/estadística & datos numéricos , Telemedicina/estadística & datos numéricos , /epidemiología , Humanos , Italia/epidemiología , Estudios Retrospectivos
4.
Med Oncol ; 37(11): 108, 2020 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-33150476

RESUMEN

BACKGROUND: Italy experienced one of the world's severest COVID-19 outbreak, with Lombardy being the most afflicted region. However, the imposed safety measures allowed to flatten the epidemic curve and hence to ease the restrictions and inaugurate, on the 4th of May 2020, the Italian phase (P) 2 of the pandemic. The present survey study, endorsed by CODRAL and AIRO-L, aimed to assess how radiotherapy (RT) departments in Lombardy have dealt with the recovery. MATERIALS AND METHODS: A questionnaire dealing with the management of pandemic was developed online and sent to all CODRAL Directors on the 10th of June 2020. Answers were collected in full anonymity one week after. RESULTS: All the 33 contacted RT facilities (100%) responded to the survey. Despite the scale of the pandemic, during P1 14 (42.4%) centres managed to safely continue the activity (≤ 10% reduction). During P2, 10 (30.3%) centres fully recovered and 14 (42.4%) reported an increase. Nonetheless, 6 (18.2%) declared no changes and, interestingly, 3 (9.1%) reduced activities. Overall, 21 centres (63.6%) reported suspected or positive cases within healthcare workforce since the beginning of the pandemic. Staff units were quarantined in 19 (57.6%) and 6 (18.2%) centres throughout P1 and P2, respectively. In the two phases, about two thirds centres registered positive or suspected cases amongst patients. CONCLUSION: The study revealed a particular attention to anti-contagion measures and a return to normal or even higher clinical workload in most RT centres in Lombardy, necessary to carry out current and previously deferred treatments.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neoplasias/epidemiología , Neoplasias/radioterapia , Servicio de Oncología en Hospital/tendencias , Neumonía Viral/epidemiología , Encuestas y Cuestionarios , Infecciones por Coronavirus/terapia , Personal de Salud/tendencias , Humanos , Italia/epidemiología , Pandemias , Equipo de Protección Personal/tendencias , Neumonía Viral/terapia
5.
Notas enferm. (Córdoba) ; 20(36): 14-21, nov.2020.
Artículo en Español | LILACS, BDENF - Enfermería, BINACIS, UNISALUD | ID: biblio-1140719

RESUMEN

El cáncer infantil se considera mayoritariamente una enfermedad crónica. La información acerca de la enfermedad y los tratamientos es una necesidad presente en todos los miembros de la familia, en los primeros momentos puede ser difícil de entender y recordar por lo cual una información clara y sencilla permitirá una mejor comprensión. Las nuevas tecnologías de la información hacen posible establecer conexiones infinitas y el campo de la salud no ha escapado a este fenómeno, han aparecido términos como "Tele cuidados" o "Tele-Enfermería", refiere al uso de las tecnologías de la información y las comunicaciones. Objetivo: evaluar los beneficios que brinda la implementación del Tele cuidado en la continuidad de los cuidados en pacientes pediátricos oncológicos y su familia. Material y Método: estudio descriptivo - evaluativo, la población fué de 9 pacientes incorporados al Proyecto de Telecuidado. Se utilizaron entrevistas, telefonía celular, fichas y listas de cotejo. El programa lleva implementado 6 meses en la institución, esta evaluación corresponde a una primera etapa de desarrollo del mismo. Resultados: según las dimensiones de Evaluación de necesidades, Evaluación de conceptualización y lógica del programa, Evaluación de proceso y Evaluación de resultados. Conclusión: El presente estudio nos ha permitido determinar al Tele Cuidado como una herramienta que nos ayuda a mejorar la atención de enfermería, además incrementa los procesos de comunicación y apoya la continuidad de los cuidados en el hogar[AU]


Childhood cancer is mostly considered a chronic disease. Information about the disease and treatments is a necessity present in all family members, in the first moments it can be difficult to understand and remember why clear information and simple it will allow a better understanding. The new information technologies make it possible to establish infinite connections and the field of Health, has not escaped this phenomenon, they have jumped into the health arena terms such as "Tele care" or "Tele-Nursing" , which refers to the use of information and communications technologies. Objective: to evaluate the benefits of implementing Tics in the continuity of care in pediatric cancer patients and their family. Material and Method: descriptive - evaluative study, the population was of 9 patients who joined the Telecare Project. Interviews, records and checklist were used. The program has been implemented for 6 months in the institution, this evaluation corresponds to a first stage of its development. Results: these are analyzed according to the dimensions of Needs Assessment, Evaluation of conceptualization and logic of the program, Process evaluation and Evaluation of results. Conclusion: This study has allowed us to determine Tele Care as a tool that helps us improve nursing care, also increases communication processes and allows continuity of care[AU]


O câncer infantil é considerado principalmente uma doença crônica. Informações sobre a doença e tratamentos são uma necessidade presente em todos os membros da família; nos primeiros momentos, pode ser difícil entender e lembrar, razão pela qual informações claras e simples permitirão uma melhor compreensão. As informações possibilitam o estabelecimento de conexões infinitas e o campo da Saúde, não escapou a esse fenômeno, foram destacados termos como "Telecare" ou "Tele- Nursing", que se referem ao uso das tecnologias da informação. e comunicações. Objetivo: avaliar os benefícios proporcionados pela implementação das TICs na continuidade do atendimento em pacientes com câncer pediátrico e sua família. Material e Método: estudo descritivo-avaliativo, a população foi de 9 pacientes que ingressaram no Projeto Telecare. Foram utilizadas entrevistas, arquivos e uma lista de verificação. O programa foi implementado por 6 meses na instituição, esta avaliação corresponde a um primeiro estágio de desenvolvimento. Resultados: são analisados de acordo com as dimensões Avaliação de Necessidades, Conceitualização de Programas e Avaliação Lógica, Avaliação de Processos e Avaliação de Resultados. Conclusão: Este estudo nos permitiu determinar o TeleCare como uma ferramenta que nos ajuda a melhorar os cuidados de enfermagem, também aumenta os processos de comunicação e permite a continuidade dos cuidados[AU]


Asunto(s)
Humanos , Masculino , Femenino , Niño , Servicio de Oncología en Hospital , Continuidad de la Atención al Paciente , Tecnología de la Información , Teleenfermería , Atención de Enfermería , Comunicación , Tics , Telepediatría
7.
Cancer Med ; 9(22): 8412-8422, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-32931637

RESUMEN

BACKGROUND: Patients with cancer are considered a high-risk group for viral pneumonia, with an increased probability of fatal outcome. Here, we investigated the clinical characteristics and outcome of patients with solid and hematological cancers and concomitant Covid-19 at a Comprehensive Cancer Center in a Covid-19 hotspot area in Germany. METHODS: We performed a retrospective single center cohort study of 39 patients with hematological and solid cancers who were hospitalized at the University Hospital Freiburg for Covid-19. Using univariate and multivariate Cox regression models we compared time to severe events and overall survival to an age-matched control cohort of 39 patients with confirmed Covid-19 without a cancer diagnosis. RESULTS: In the cancer cohort 29 patients had a diagnosis of a solid tumor, and 10 had a hematological malignancy. In total, eight patients (21%) in the cancer and 14 patients (36%) from the noncancer cohort died during the observation period. Presence of a malignancy was not significantly associated with survival or time to occurrence of severe events. Major influences on mortality were high IL-6 levels at Covid-19 diagnosis (HR = 6.95, P = .0121) and age ≥ 65 years (HR = 6.22, P = .0156). CONCLUSIONS: Compared to an age-matched noncancer cohort, we did not observe an association between a cancer diagnosis and a more severe disease course or higher fatality rate in patients with Covid-19. Patients with a hematological malignancy showed a trend towards a longer duration until clinical improvement and longer hospitalization time compared to patients with a solid cancer. Cancer per se does not seem to be a confounder for dismal outcome in Covid-19.


Asunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Neoplasias Hematológicas/epidemiología , Hospitalización/estadística & datos numéricos , Neoplasias/epidemiología , Servicio de Oncología en Hospital/tendencias , Neumonía Viral/complicaciones , Anciano , Anciano de 80 o más Años , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Femenino , Alemania/epidemiología , Neoplasias Hematológicas/virología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/virología , Pandemias , Neumonía Viral/transmisión , Neumonía Viral/virología , Pronóstico , Estudios Retrospectivos , Factores de Riesgo , Tasa de Supervivencia
8.
ESMO Open ; 5(5)2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32878898

RESUMEN

BACKGROUND: During the COVID-19 outbreak, healthcare professionals (HCP) are at the frontline of clinical management and at increased risk for infection. The SARS-CoV-2 seroprevalence of oncological HCP and their patients has significant implications for oncological care. METHODS: HCP and patients with cancer at the Division of Oncology, Medical University of Vienna were included between 21 March and 4 June and tested for total antibodies against SARS-CoV-2 employing the Roche Elecsys Anti-SARS-CoV-2 immunoassay. Reactive samples were confirmed or disproved by the Abbott SARS-CoV-2 IgG test. Additionally, a structured questionnaire regarding basic demographic parameters, travel history and COVID-19-associated symptoms had to be completed by HCP. RESULTS: 146 subjects (62 HCP and 84 patients with cancer) were enrolled. In the oncological HCP cohort, 20 (32.3%) subjects were medical oncologists, 28 (45.2%) nurses at our ward and 14 (22.6%) fulfil other functions such as study coordinators. In the patient cohort, most individuals are on active anticancer treatment (96.4%). 26% of the HCP and 6% of the patients had symptoms potentially associated with COVID-19 since the end of February 2020. However, only in 2 (3.2%) HCP and in 3 (3.6%) patients, anti-SARS-Cov-2 total antibodies were detected. The second assay for anti-SARS-Cov-2 IgG antibodies confirmed the positive result in all HCP and in 2 (2.4%) patients, suggesting an initial assay's unspecific reaction in one case. In individuals with a confirmed test result, an active COVID-19 infection was documented by a positive SARS-CoV-2 RNA PCR test. CONCLUSION: Specific anti-SARS-CoV-2 antibodies were found solely in persons after a documented SARS-CoV-2 viral infection, thus supporting the test methods' high sensitivity and specificity. The low prevalence of anti-SARS-CoV-2 antibodies in our cohorts indicates a lack of immunity against SARS-CoV-2. It highlights the need for continued strict safety measures to prevent uncontrolled viral spread among oncological HCPs and patients with cancer.


Asunto(s)
Anticuerpos Antivirales/sangre , Betacoronavirus/inmunología , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Cuerpo Médico de Hospitales , Servicio de Oncología en Hospital , Pacientes , Neumonía Viral/diagnóstico , Pruebas Serológicas , Centros de Atención Terciaria , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Austria/epidemiología , Betacoronavirus/patogenicidad , Biomarcadores/sangre , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/transmisión , Infecciones por Coronavirus/virología , Femenino , Interacciones Huésped-Patógeno , Humanos , Masculino , Persona de Mediana Edad , Personal de Enfermería en Hospital , Oncólogos , Enfermería Oncológica , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/transmisión , Neumonía Viral/virología , Valor Predictivo de las Pruebas , Estudios Prospectivos , Reproducibilidad de los Resultados , Estudios Retrospectivos , Estudios Seroepidemiológicos , Adulto Joven
9.
JAMA Oncol ; 6(9): 1429-1433, 2020 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-32761149

RESUMEN

Importance: The coronavirus disease 2019 (COVID-19) pandemic has forced oncology clinicians and administrators in the United States to set priorities for cancer care owing to resource constraints. As oncology practices adapt to a contracted health care system, expertise gained from partnerships in low-resource settings can be used for guidance. This article provides a primer on priority setting in oncology and ethical guidance based on lessons learned from experience with cancer care priority setting in low-resource settings. Observations: Lessons learned from real-world experiences are myriad. First, in the setting of limited resources, a utilitarian approach to maximizing survival benefit should guide decision-making. Second, conflicting principles will often arise among stakeholders and decision makers. Third, fair decision-making procedures should be established to ensure moral legitimacy and accountability. Fourth, proactive safeguards must be implemented to protect vulnerable individuals, or disparities in cancer treatment and outcomes will only widen further. Fifth, communication with patients and families about priority setting decisions should be intentional and standardized. Sixth, moral distress among clinicians must be addressed to avoid burnout during a time when resilience is critical. Conclusions and Relevance: Although the need to triage cancer care may be new to those who underwent training and now practice oncology in high-resource settings, it is familiar for those who practice in low- and middle-income countries. Oncologists in the United States facing unprecedented decisions about prioritization can draw on ethical frameworks and lessons learned from real-world cancer care priority setting in resource-constrained environments.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neoplasias/epidemiología , Servicio de Oncología en Hospital , Pandemias , Neumonía Viral/epidemiología , Betacoronavirus/patogenicidad , Comunicación , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/virología , Toma de Decisiones , Recursos en Salud , Humanos , Neoplasias/complicaciones , Neoplasias/virología , Neumonía Viral/complicaciones , Neumonía Viral/virología , Estados Unidos/epidemiología
10.
Cancer Control ; 27(3): 1073274820941973, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32755231

RESUMEN

The world is facing the pandemic linked to COVID-19 virus infection that has rapidly spread worldwide, and severe complications have been reported to occur in around a third of patients. To date, there is no approved vaccine or specific therapy against COVID-19, but many trials are ongoing with some of them showing promising results. It has been shown recently that patients with cancer are at high risk of infection and they are more susceptible to develop severe events such as the necessity of invasive ventilation and death. Therefore, this crisis presents a real challenge for health systems especially in low- and middle-income countries where the health systems are already fragile such as African countries. In this article, we describe the epidemiological situation of the infection in Morocco and the different challenges in cancer centers in the era of COVID-19, in addition to various strategies that have been implemented to prevent and control the infection spread in oncological units in order to ensure the continuation of adequate cancer care.


Asunto(s)
Instituciones Oncológicas/normas , Instituciones Oncológicas/tendencias , Infecciones por Coronavirus/prevención & control , Neoplasias/terapia , Pandemias/prevención & control , Neumonía Viral/prevención & control , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Prestación de Atención de Salud , Humanos , Marruecos/epidemiología , Neoplasias/diagnóstico , Neoplasias/epidemiología , Servicio de Oncología en Hospital , Neumonía Viral/epidemiología
11.
JCO Glob Oncol ; 6: 1017-1023, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32634067

RESUMEN

PURPOSE: After coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO, a response from the Italian Health System to react to an unprecedented condition became necessary and sudden. The COVID-19 pandemic has required oncologists to redefine clinical organization and patient management. The purpose of our study was to document the difficulties emerging during the SARS-CoV-2 pandemic in Italian oncology. METHODS: We broadcasted an electronic survey to oncologic health care professionals. It consisted of 45 questions ranging from individual perception of pandemic management by hospital centers to physicians' and nurses' psychological distress and patient care. RESULTS: A total of 383 oncology health workers participated in the survey. The majority were female (71.8%) and from central Italy (46.2%). Impressively, a total of 357 (93%) participants declared the oncologic department reorganized routine clinical activity, but only 40.5% were adequately trained about the required procedures; 20% of the survey respondents think they have not received adequate and timely protective devices. CONCLUSION: Our survey demonstrated the flexibility of oncologic teams. However, the emergency response quality has been heterogeneous, and several drawbacks have emerged from the first analyses investigating how the world of oncology changes in the COVID-19 pandemic. Information, protection, testing, and training of health care professionals are key words that should be kept in mind to encourage recovery after this tragedy and to be ready to face a similar emergency in the future.


Asunto(s)
Actitud del Personal de Salud , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pautas de la Práctica en Enfermería/estadística & datos numéricos , Pautas de la Práctica en Medicina/estadística & datos numéricos , Distrés Psicológico , Adulto , Anciano , Betacoronavirus , Prestación de Atención de Salud , Femenino , Hospitales , Humanos , Control de Infecciones , Italia/epidemiología , Masculino , Oncología Médica , Persona de Mediana Edad , Enfermeras y Enfermeros/psicología , Oncólogos/psicología , Enfermería Oncológica , Servicio de Oncología en Hospital/organización & administración , Pandemias , Encuestas y Cuestionarios
13.
Oncology (Williston Park) ; 34(5): 156-162, 2020 05 13.
Artículo en Inglés | MEDLINE | ID: mdl-32644174

RESUMEN

The coronavirus disease 2019 pandemic has rapidly placed tremendous stress on health systems around the world. In response, multiple health systems have postponed elective surgeries in order to conserve hospital beds and personal protective equipment, minimize patient traffic, and prevent unnecessary utilization and exposure of healthcare workers. The American College of Surgeons released the following statement on March 13, 2020: "Each hospital, health system and surgeon should thoughtfully review all scheduled elective procedures with a plan to minimize, postpone, or cancel electively scheduled operations, endoscopes, or other invasive procedures until we have passed the predicted inflection point in the exposure graph and can be confident that our health care infrastructure can support a potentially rapid and overwhelming uptick in critical patient care needs." In our state, North Carolina, Governor Roy Cooper requested that all hospitals postpone elective and non-urgent procedures and surgeries effective March 23, 2020.


Asunto(s)
Infecciones por Coronavirus , Procedimientos Quirúrgicos Electivos/métodos , Escisión del Ganglio Linfático/métodos , Servicio de Oncología en Hospital , Pandemias , Neumonía Viral , Prostatectomía/métodos , Neoplasias de la Próstata , Ajuste de Riesgo/métodos , Gestión de Riesgos , Betacoronavirus , Gestión del Cambio , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Humanos , Control de Infecciones/métodos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , North Carolina , Servicio de Oncología en Hospital/organización & administración , Servicio de Oncología en Hospital/tendencias , Pandemias/prevención & control , Selección de Paciente , Atención Dirigida al Paciente/organización & administración , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neoplasias de la Próstata/epidemiología , Neoplasias de la Próstata/patología , Neoplasias de la Próstata/cirugía , Gestión de Riesgos/métodos , Gestión de Riesgos/tendencias
15.
Int J Gynecol Cancer ; 30(7): 917-919, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32448805

RESUMEN

INTRODUCTION: The outbreak of coronavirus disease 2019 (COVID-19) has spread to many countries and has been declared a global health emergency. Our center is located in the south of Italy where the infection rates were low and the clusters of COVID-19 positive patients were small and inhomogeneous. The aim of this short report is to share our experience as a starting point for the management of the steady state of the pandemic. METHODS: The safety of the patients and department staff required a strict plan to minimize the risk of infection between operators whose absence would have made it impossible to carry out the radiotherapy treatments. The head of the radiotherapy unit and members of the Hospital Crisis Unit have put in place a series of measures to manage the emergency. RESULTS: A "clean" team has been established whose members are kept out of the radiotherapy unit for 2 weeks on rotation. Several separate work areas have been made in order to reduce direct contact between the staff. Each staff member has to wear protective equipment if close contact with patients is required. Before confirming a radiotherapy consult or a follow-up visit, telephone clinical and epidemiological screening is performed by nurses through a questionnaire regarding the presence of respiratory symptoms or eventual social contacts with COVID-19 positive people. Once the patients arrive in the hospital, a triage point at the entrance to the hospital performs a second screening and a temperature check. CONCLUSIONS: This management experience of a radiotherapy unit in Southern Italy could serve as a useful example for the future. In fact, in the steady state of infection many centers may face epidemiologically contagious numbers similar to those that we currently have in our region. These numbers require the maintenance of alert and precautionary measures which in our case seem to have worked.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Control de Infecciones/métodos , Transmisión de Enfermedad Infecciosa de Paciente a Profesional/prevención & control , Transmisión de Enfermedad Infecciosa de Profesional a Paciente/prevención & control , Neoplasias/radioterapia , Servicio de Oncología en Hospital/organización & administración , Pandemias/prevención & control , Neumonía Viral/prevención & control , Técnicas de Laboratorio Clínico , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/transmisión , Humanos , Control de Infecciones/organización & administración , Italia , Neumonía Viral/diagnóstico , Neumonía Viral/transmisión , Oncología por Radiación/organización & administración , Triaje
16.
Washington, D.C.; PAHO; 2020-05-26. (PAHO/EIH/HA/COVID-19/20-0004).
en Inglés | PAHO-IRIS | ID: phr-52263

RESUMEN

Since the onset of the COVID-19 pandemic, health systems around the world have focused on reorganizing healthcare services and prioritizing hospital beds and intensive care units to manage people with COVID-19. This has included the suspension or reduction of elective cancer care and clinical visits for assessment, diagnosis and management, except for high-risk cancer patients. It has been noted that people who have COVID-19 and an underlying condition such as cancer have higher mortality than those without cancer. In addition, people with cancer are more likely to have complications from COVID-19. Despite strategies to maintain health services such as hemodialysis, oncology, chemotherapy, and others, there has been a significant reduction in access to service for patients who were being diagnosed or treated for cancer, due to their high risk. Studies have demonstrated that delays in cancer diagnosis and treatment have an impact on the progression of cancer. This could lead to future peaks in mortality from potentially curable cancers, as a result of not receiving standard treatment. For this reason, cancer services should rapidly manage and avoid any cumulative delays in treatment and prevent an increase in avoidable deaths from cancer.


Asunto(s)
Infecciones por Coronavirus , Neoplasias , Coronavirus , Enfermedad Crónica , Servicio de Oncología en Hospital
17.
Washington, D.C.; OPS; 2020-05-26. (OPS/EIH/HA/COVID-19/20-0004).
en Español | PAHO-IRIS | ID: phr-52218

RESUMEN

La organización de los servicios de atención de pacientes con cáncer (niños, adolescentes y adultos) es crucial para poder brindar una respuesta oportuna y de calidad en el contexto de la pandemia de COVID-19. Se debe considerar el impacto sobre la disponibilidad de los medicamentos oncológicos y otras tecnologías sanitarias, y la carga de trabajo de los laboratorios y los servicios de radiología, con el fin de proveer servicios accesibles y equitativos a los pacientes con cáncer.


Asunto(s)
Infecciones por Coronavirus , Coronavirus , Neoplasias , Enfermedad Crónica , Servicio de Oncología en Hospital
18.
Washington; Organización Panamericana de la Salud; mayo 26, 2020.
No convencional en Inglés, Español | LILACS | ID: biblio-1097253

RESUMEN

La organización de los servicios de atención de pacientes con cáncer (niños, adolescentes y adultos) es crucial para poder brindar una respuesta oportuna y de calidad en el contexto de la pandemia de COVID-19. Se debe considerar el impacto sobre la disponibilidad de los medicamentos oncológicos y otras tecnologías sanitarias, y la carga de trabajo de los laboratorios y los servicios de radiología, con el fin de proveer servicios accesibles y equitativos a los pacientes con cáncer.


Since the onset of the COVID-19 pandemic, health systems around the world have focused on reorganizing healthcare services and prioritizing hospital beds and intensive care units to manage people with COVID-19. This has included the suspension or reduction of elective cancer care and clinical visits for assessment, diagnosis and management, except for high-risk cancer patients. It has been noted that people who have COVID-19 and an underlying condition such as cancer have higher mortality than those without cancer. In addition, people with cancer are more likely to have complications from COVID-19. Despite strategies to maintain health services such as hemodialysis, oncology, chemotherapy, and others, there has been a significant reduction in access to service for patients who were being diagnosed or treated for cancer, due to their high risk. Studies have demonstrated that delays in cancer diagnosis and treatment have an impact on the progression of cancer. This could lead to future peaks in mortality from potentially curable cancers, as a result of not receiving standard treatment. For this reason, cancer services should rapidly manage and avoid any cumulative delays in treatment and prevent an increase in avoidable deaths from cancer.


Asunto(s)
Humanos , Neumonía Viral , Instituciones Oncológicas/organización & administración , Servicio de Oncología en Hospital/organización & administración , Infecciones por Coronavirus/prevención & control , Pandemias/prevención & control , Betacoronavirus
19.
Breast ; 52: 8-16, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32334323

RESUMEN

The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) associated disease (COVID-19) outbreak seriously challenges globally all health care systems and professionals. Expert projections estimate that despite social distancing and lockdown being practiced, we have yet to feel the full impact of COVID-19. In this manuscript we provide guidance to prepare for the impact of COVID-19 pandemic on breast cancer patients and advise on how to triage, prioritize and organize diagnostic procedures, surgical, radiation and medical treatments.


Asunto(s)
Neoplasias de la Mama/terapia , Infecciones por Coronavirus/epidemiología , Prestación de Atención de Salud/métodos , Neumonía Viral/epidemiología , Guías de Práctica Clínica como Asunto , Triaje/métodos , Betacoronavirus , Humanos , Servicio de Oncología en Hospital , Pandemias , Medición de Riesgo
20.
BMC Palliat Care ; 19(1): 31, 2020 Mar 12.
Artículo en Inglés | MEDLINE | ID: mdl-32164672

RESUMEN

BACKGROUND: Palliative care (PC) referral is recommended early in the course of advanced cancer. This study aims to describe, in an integrated onco-palliative care program (IOPC), patient's profile when first referred to this program, timing of this referral and its impact on the trajectory of care at end-of-life. METHODS: The IOPC combined the weekly onco-palliative meeting (OPM) dedicated to patients with incurable cancer, and/or the clinical evaluation by the PC team. Oncologists can refer to the multidisciplinary board of the OPM the patients for whom goals and organization of care need to be discussed. We analyzed all patients first referred at OPM in 2011-2013. We defined the index of precocity (IP), as the ratio of the time from first referral to death by the time from diagnosis of incurability to death, ranging from 0 (late referral) to 1 (early referral). RESULTS: Of the 416 patients included, 57% presented with lung, urothelial cancers, or sarcoma. At first referral to IOPC, 76% were receiving antitumoral treatment, 63% were outpatients, 56% had a performance status ≤2 and 46% had a serum albumin level > 35 g/l. The median [1st-3rd quartile] IP was 0.39 [0.16-0.72], ranging between 0.53 [0.20-0.79] (earliest referral, i.e. close to diagnosis of incurability, for lung cancer) to 0.16 [0.07-0.56] (latest referral, i.e. close to death relatively to length of metastatic disease, for prostate cancer). Among 367 decedents, 42 (13%) received antitumoral treatment within 14 days before death, and 157 (43%) died in PC units. CONCLUSIONS: The IOPC is an effective organization to enable early integration of PC and decrease aggressiveness of care near the end-of life. The IP is a useful tool to model the timing of referral to IOPC, while taking into account each cancer types and therapeutic advances.


Asunto(s)
Toma de Decisiones Conjunta , Servicio de Oncología en Hospital/normas , Derivación y Consulta/normas , Factores de Tiempo , Anciano , Prestación Integrada de Atención de Salud/métodos , Prestación Integrada de Atención de Salud/normas , Prestación Integrada de Atención de Salud/tendencias , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/clasificación , Neoplasias/terapia , Servicio de Oncología en Hospital/organización & administración , Servicio de Oncología en Hospital/tendencias , Cuidados Paliativos/métodos , Cuidados Paliativos/normas , Cuidados Paliativos/tendencias , Derivación y Consulta/tendencias , Estudios Retrospectivos , Cuidado Terminal/organización & administración , Cuidado Terminal/normas , Cuidado Terminal/tendencias
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...