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1.
Medicine (Baltimore) ; 100(5): e24409, 2021 Feb 05.
Artículo en Inglés | MEDLINE | ID: mdl-33592888

RESUMEN

ABSTRACT: Infection with the SARS-CoV-2 virus seems to contribute significantly to increased postoperative complications and mortality after emergency surgical procedures. Additionally, the fear of COVID-19 contagion delays the consultation of patients, resulting in the deterioration of their acute diseases by the time of consultation. In the specific case of urgent digestive surgery patients, both factors significantly worsen the postoperative course and prognosis. Main working hypothesis: infection by COVID-19 increases postoperative 30-day-mortality for any cause in patients submitted to emergency/urgent general or gastrointestinal surgery. Likewise, hospital collapse during the first wave of the COVID-19 pandemic increased 30-day-mortality for any cause. Hence, the main objective of this study is to estimate the cumulative incidence of mortality at 30-days-after-surgery. Secondary objectives are: to estimate the cumulative incidence of postoperative complications and to develop a specific postoperative risk propensity model for COVID-19-infected patients.A multicenter, observational retrospective cohort study (COVID-CIR-study) will be carried out in consecutive patients operated on for urgent digestive pathology. Two cohorts will be defined: the "pandemic" cohort, which will include all patients (classified as COVID-19-positive or -negative) operated on for emergency digestive pathology during the months of March to June 2020; and the "control" cohort, which will include all patients operated on for emergency digestive pathology during the months of March to June 2019. Information will be gathered on demographic characteristics, clinical and analytical parameters, scores on the usual prognostic scales for quality management in a General Surgery service (POSSUM, P-POSSUM and LUCENTUM scores), prognostic factors applicable to all patients, specific prognostic factors for patients infected with SARS-CoV-2, postoperative morbidity and mortality (at 30 and 90 postoperative days). The main objective is to estimate the cumulative incidence of mortality at 30 days after surgery. As secondary objectives, to estimate the cumulative incidence of postoperative complications and to develop a specific postoperative risk propensity model for SARS-CoV-2 infected patients.The protocol (version1.0, April 20th 2020) was approved by the local Institutional Review Board (Ethic-and-Clinical-Investigation-Committee, code PR169/20, date 05/05/20). The study findings will be submitted to peer-reviewed journals and presented at relevant national and international scientific meetings.ClinicalTrials.gov Identifier: NCT04479150 (July 21, 2020).


Asunto(s)
Enfermedades del Sistema Digestivo , Procedimientos Quirúrgicos del Sistema Digestivo , Tratamiento de Urgencia , Control de Infecciones , Complicaciones Posoperatorias , Tiempo de Tratamiento , Adulto , /prevención & control , Enfermedades del Sistema Digestivo/diagnóstico , Enfermedades del Sistema Digestivo/epidemiología , Enfermedades del Sistema Digestivo/mortalidad , Enfermedades del Sistema Digestivo/cirugía , Procedimientos Quirúrgicos del Sistema Digestivo/efectos adversos , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Procedimientos Quirúrgicos del Sistema Digestivo/mortalidad , Urgencias Médicas/epidemiología , Tratamiento de Urgencia/efectos adversos , Tratamiento de Urgencia/métodos , Tratamiento de Urgencia/mortalidad , Femenino , Humanos , Incidencia , Control de Infecciones/métodos , Control de Infecciones/estadística & datos numéricos , Masculino , Mortalidad , Estudios Multicéntricos como Asunto , Estudios Observacionales como Asunto , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Proyectos de Investigación , Medición de Riesgo/métodos
2.
Sci Rep ; 11(1): 717, 2021 01 12.
Artículo en Inglés | MEDLINE | ID: mdl-33436848

RESUMEN

Coronavirus disease-2019 (COVID-19) pandemic has affected millions of people since December 2019. Summarizing the development of COVID-19 and assessing the effects of control measures are very critical to China and other countries. A logistic growth curve model was employed to compare the development of COVID-19 before and after the emergency response took effect. We found that the number of confirmed cases peaked 9-14 days after the first detection of an imported case, but there was a peak lag in the province where the outbreak was concentrated. Results of the growth curves indicated that the fitted cumulative confirmed cases were close to the actual observed cases, and the R2 of all models was above 0.95. The average growth rate decreased by 44.42% nationally and by 32.5% outside Hubei Province. The average growth rate in the 12 high-risk areas decreased by 29.9%. The average growth rate of cumulative confirmed cases decreased by approximately 50% after the emergency response. Areas with frequent population migration have a high risk of outbreak. The emergency response taken by the Chinese government was able to effectively control the COVID-19 outbreak. Our study provides references for other countries and regions to control the COVID-19 outbreak.


Asunto(s)
/epidemiología , Control de Enfermedades Transmisibles/estadística & datos numéricos , /prevención & control , China , Control de Enfermedades Transmisibles/normas , Urgencias Médicas/epidemiología , Humanos , Análisis Espacio-Temporal
6.
BMC Pediatr ; 20(1): 562, 2020 12 23.
Artículo en Inglés | MEDLINE | ID: mdl-33353540

RESUMEN

BACKGROUND: Coronavirus disease 2019 (COVID-19) has impacted the provision of health services in all specialties. We aim to study the impact of COVID-19 on the utilization of pediatric hospital services including emergency department (ED) attendances, hospitalizations, diagnostic categories and resource utilization in Singapore. METHODS: We performed a retrospective review of ED attendances and hospital admissions among children < 18 years old from January 1st to August 8th 2020 in a major pediatric hospital in Singapore. Data were analyzed in the following time periods: Pre-lockdown (divided by the change in Disease Outbreak Response System Condition (DORSCON) level), during-lockdown and post-lockdown. We presented the data using proportions and percentage change in mean counts per day with the corresponding 95% confidence intervals (CIs). RESULTS: We attended to 58,367 children with a mean age of 5.1 years (standard deviation, SD 4.6). The mean ED attendance decreased by 331 children/day during lockdown compared to baseline (p < 0.001), attributed largely to a drop in respiratory (% change - 87.9, 95% CI - 89.3 to - 86.3, p < 0.001) and gastrointestinal infections (% change - 72.4, 95%CI - 75.9 to - 68.4, p < 0.001). Trauma-related diagnoses decreased at a slower rate across the same periods (% change - 40.0, 95%CI - 44.3 to - 35.3, p < 0.001). We saw 226 children with child abuse, with a greater proportion of total attendance seen post-lockdown (79, 0.6%) compared to baseline (36, 0.2%) (p < 0.001). In terms of ED resource utilization, there was a decrease in the overall mean number of procedures performed per day during the lockdown compared to baseline, driven largely by a reduction in blood investigations (% change - 73.9, 95%CI - 75.9 to - 71.7, p < 0.001). CONCLUSIONS: We highlighted a significant decrease in infection-related presentations likely attributed to the lockdown and showed that the relative proportion of trauma-related attendances increased. By describing the impact of COVID-19 on health services, we report important trends that may provide guidance when planning resources for future pandemics.


Asunto(s)
/epidemiología , Urgencias Médicas/epidemiología , Hospitalización/tendencias , Pandemias , Preescolar , Servicio de Urgencia en Hospital/tendencias , Femenino , Humanos , Masculino , Estudios Retrospectivos , Singapur/epidemiología
7.
Acta Med Port ; 33(11): 733-741, 2020 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-33160423

RESUMEN

INTRODUCTION: Portugal took early action to control the COVID-19 epidemic, initiating lockdown measures on March 16th when it recorded only 62 cases of COVID-19 per million inhabitants and reported no deaths. The Portuguese public complied quickly, reducing their overall mobility by 80%. The aim of this study was to estimate the initial impact of the lockdown in Portugal in terms of the reduction of the burden on the healthcare system. MATERIAL AND METHODS: We forecasted epidemic curves for: Cases, hospital inpatients (overall and in intensive care), and deaths without lockdown, assuming that the impact of containment measures would start 14 days after initial lockdown was implemented. We used exponential smoothing models for deaths, intensive care and hospitalizations and an ARIMA model for number of cases. Models were selected considering fitness to the observed data up to the 31st March 2020. We then compared observed (with intervention) and forecasted curves (without intervention). RESULTS: Between April 1st and April 15th, there were 146 fewer deaths (-25%), 5568 fewer cases (-23%) and, as of April 15th, there were 519 fewer intensive care inpatients (-69%) than forecasted without the lockdown. On April 15th, the number of intensive care inpatients could have reached 748, three times higher than the observed value (229) if the intervention had been delayed. DISCUSSION: If the lockdown had not been implemented in mid-March, Portugal intensive care capacity (528 beds) would have likely been breached during the first half of April. The lockdown seems to have been effective in reducing transmission of SARS-CoV-2, serious COVID-19 disease, and associated mortality, thus decreasing demand on health services. CONCLUSION: An early lockdown allowed time for the National Health Service to mobilize resources and acquire personal protective equipment, increase testing, contact tracing and hospital and intensive care capacity and to promote broad prevention and control measures. When lifting more stringent measures, strong surveillance and communication strategies that mobilize individual prevention efforts are necessary.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/prevención & control , Urgencias Médicas/epidemiología , Epidemias/prevención & control , Pandemias/prevención & control , Neumonía Viral/prevención & control , Política Pública/legislación & jurisprudencia , Cuarentena/métodos , Ocupación de Camas , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/transmisión , Cuidados Críticos/estadística & datos numéricos , Epidemias/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Humanos , Neumonía Viral/epidemiología , Neumonía Viral/mortalidad , Neumonía Viral/transmisión , Portugal/epidemiología , Cuarentena/estadística & datos numéricos
8.
Minerva Chir ; 75(5): 320-327, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33210528

RESUMEN

BACKGROUND: During Coronavirus disease (COVID-19) pandemic entire countries rapidly ran out of intensive care beds, occupied by critically ill infected patients. Elective surgery was initially halted and acute non-deferrable surgical care drastically limited. The presence of COVID-19 patients into intensive care units (ICU) is currently decreasing but their congestion have restricted our therapeutic strategies during the last months. METHODS: In the COVID-19 era eighteen patients (8 men, 10 women) with a mean age of 80 years, needing undelayable abdominal surgery underwent awake open surgery at our Department. Prior to surgery, all patients underwent COVID-19 investigation. In all cases locoregional anesthesia (LA) was performed. Intraoperative and postoperative pain has been monitored and regularly assessed. A distinct pathway has been set up to keep patients of uncertain COVID-19 diagnosis separated from all other patients. RESULTS: Mean operative time was 104 minutes. In only one case conversion to general anesthesia was necessary. Postoperative pain was always well controlled. None of them required postoperative intensive care support. Only one perioperative complication occurred. Early readmissions after surgery were never observed. CONCLUSIONS: On the basis of our experience awake laparotomy under LA resulted feasible, safe, painless and, in specific cases, the only viable option. For patients presenting fragile cardiovascular and respiratory, reserves and in whom general anesthesia (GA) would presumably increase morbidity and mortality we encourage LA as an alternative to GA. In the COVID-19 era, it has become part of our ICU-preserving strategy allowing us to carry out undeferrable surgeries.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Anciano Frágil , Laparotomía/estadística & datos numéricos , Neumonía Viral/epidemiología , Anciano , Anciano de 80 o más Años , Anestesia General , Anestesia Local/métodos , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Urgencias Médicas/epidemiología , Femenino , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Tempo Operativo , Dolor Postoperatorio/prevención & control , Pandemias , Neumonía Viral/diagnóstico , Procedimientos Quirúrgicos Operativos/estadística & datos numéricos
10.
Medicina (Kaunas) ; 56(10)2020 Oct 12.
Artículo en Inglés | MEDLINE | ID: mdl-33053765

RESUMEN

Background and objectives: The coronavirus disease 2019 (COVID-19) pandemic is overwhelming Japan's intensive care capacity. This study aimed to determine the number of patients with COVID-19 who required intensive care and to compare the numbers with Japan's intensive care capacity. Materials and Methods: Publicly available datasets were used to obtain the number of confirmed patients with COVID-19 undergoing mechanical ventilation and extracorporeal membrane oxygenation (ECMO) between 15 February and 19 July 2020 to determine and compare intensive care unit (ICU) and attending bed needs for patients with COVID-19, and to estimate peak ICU demands in Japan. Results: During the epidemic peak in late April, 11,443 patients (1.03/10,000 adults) had been infected, 373 patients (0.034/10,000 adults) were in ICU, 312 patients (0.028/10,000 adults) were receiving mechanical ventilation, and 62 patients (0.0056/10,000 adults) were under ECMO per day. At the peak of the epidemic, the number of infected patients was 651% of designated beds, and the number of patients requiring intensive care was 6.0% of ICU beds, 19.1% of board-certified intensivists, and 106% of designated medical institutions in Japan. Conclusions: The number of critically ill patients with COVID-19 continued to rise during the pandemic, exceeding the number of designated beds but not exceeding ICU capacity.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Cuidados Críticos/estadística & datos numéricos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Enfermedad Crítica/epidemiología , Urgencias Médicas/epidemiología , Humanos , Japón , Masculino , Pandemias
11.
Emerg Med J ; 37(12): 773-777, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33127743

RESUMEN

BACKGROUND: Public health mitigation strategies in British Columbia during the pandemic included stay-at-home orders and closure of non-essential services. While most primary physicians' offices were closed, hospitals prepared for a pandemic surge and emergency departments (EDs) stayed open to provide care for urgent needs. We sought to determine whether ED paediatric presentations prior and during the COVID-19 pandemic changed and review acuity compared with seasonal adjusted prior year. METHODS: We analysed records from 18 EDs in British Columbia, Canada, serving 60% of the population. We included children 0-16 years old and excluded those with no recorded acuity or discharge disposition and those left without being seen by a physician. We compared prepandemic (before the first COVID-19 case), early pandemic (after first COVID-19 case) and peak pandemic (during public health emergency) periods as well as a similar time from the previous year. RESULTS: A reduction of 57% and 70% in overall visits was recorded in the children's hospital ED and the general hospitals EDs, respectively. Average daily visits declined significantly during the peak-pandemic period (167.44±40.72) compared with prepandemic period (543.53±58.8). Admission rates increased mainly due to the decrease in the rate of visits with lower acuity. Children with complaints of 'fever' and 'gastrointestinal' symptoms had both the largest overall volume and per cent reduction in visits between peak-pandemic and prior year (79% and 74%, respectively). CONCLUSION: Paediatric emergency medicine attendances were reduced to one-third of normal numbers during the 2020 COVID-19 lockdown in British Columbia, Canada, with the reduction mainly seen in minor illnesses that do not usually require admission.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Medicina de Emergencia/organización & administración , Servicio de Urgencia en Hospital/organización & administración , Hospitales Pediátricos/organización & administración , Neumonía Viral/epidemiología , Adolescente , Betacoronavirus/patogenicidad , Colombia Británica/epidemiología , Niño , Preescolar , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/transmisión , Urgencias Médicas/epidemiología , Medicina de Emergencia/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Femenino , Accesibilidad a los Servicios de Salud/organización & administración , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Hospitales Pediátricos/estadística & datos numéricos , Humanos , Lactante , Recién Nacido , Masculino , Pandemias/prevención & control , Admisión del Paciente/estadística & datos numéricos , Alta del Paciente/estadística & datos numéricos , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Neumonía Viral/transmisión , Triaje/organización & administración , Triaje/estadística & datos numéricos
12.
Ann Emerg Med ; 76(5): 595-601, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33008651

RESUMEN

STUDY OBJECTIVE: In the initial period of the coronavirus disease 2019 (COVID-19) pandemic, there has been a substantial decrease in the number of patients seeking care in the emergency department. A first step in estimating the impact of these changes is to characterize the patients, visits, and diagnoses for whom care is being delayed or deferred. METHODS: We conducted an observational study, examining demographics, visit characteristics, and diagnoses for all ED patient visits to an urban level 1 trauma center before and after a state emergency declaration and comparing them with a similar period in 2019. We estimated percent change on the basis of the ratios of before and after periods with respect to 2019 and the decline per week using Poisson regression. Finally, we evaluated whether each factor modified the change in overall ED visits. RESULTS: After the state declaration, there was a 49.3% decline in ED visits overall, 35.2% (95% confidence interval -38.4 to -31.9) as compared with 2019. Disproportionate declines were seen in visits by pediatric and older patients, women, and Medicare recipients, as well as for presentations of syncope, cerebrovascular accidents, urolithiasis, and abdominal and back pain. Significant proportional increases were seen in ED visits for upper respiratory infections, shortness of breath, and chest pain. CONCLUSION: There have been significant changes in patterns of care seeking during the COVID-19 pandemic. Declines in ED visits, especially for certain demographic groups and disease processes, should prompt efforts to understand these phenomena, encourage appropriate care seeking, and monitor for the morbidity and mortality that may result from delayed or deferred care.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Urgencias Médicas/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Pandemias , Aceptación de la Atención de Salud/estadística & datos numéricos , Neumonía Viral/epidemiología , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Estados Unidos/epidemiología
14.
Dtsch Arztebl Int ; 117(33-34): 545-552, 2020 08 17.
Artículo en Inglés | MEDLINE | ID: mdl-32865489

RESUMEN

BACKGROUND: In this study, we investigate the number of emergency room consultations during the COVID-19 pandemic of 2020 in Germany compared to figures from the previous year. METHODS: Case numbers from calendar weeks 1 through 22 of the two consecutive years 2019 and 2020 were obtained from 29 university hospitals and 7 non-university hospitals in Germany. Information was also obtained on the patients' age, sex, and urgency, along with the type of case (outpatient/inpatient), admitting ward, and a small number of tracer diagnoses (I21, myocardial infarction; J44, COPD; and I61, I63, I64, G45, stroke /TIA), as well as on the number of COVID-19 cases and of tests performed for SARS-CoV-2, as a measure of the number of cases in which COVID-19 was suspected or at least included in the differential diagnoses. RESULTS: A total of 1 022 007 emergency room consultations were analyzed, of which 546 940 took place in 2019 and 475 067 in 2020. The number of consultations with a positive test for the COVID-19 pathogen was 3122. The total number of emergency room consultations in the observation period was 13% lower in 2020 than in 2019, with a maximum drop by 38% coinciding with the highest number of COVID-19 cases (calendar week 14; 572 cases). After the initiation of interpersonal contact restrictions in 2020, there was a marked drop in COVID-19 case numbers, by a mean of -240 cases per week per emergency room (95% confidence interval [-284; -128]). There was a rise in case numbers thereafter, by a mean of 17 patients per week [14; 19], and the number of cases of myocardial infarction returned fully to the level seen in 2019. CONCLUSION: In Germany, the COVID-19 pandemic led to a significant drop in medical emergencies of all kinds presenting to the nation's emergency departments. A recovery effect began to be seen as early as calendar week 15, but the levels seen in 2019 were not yet reached overall by calendar week 22; only the prevalence of myocardial infarction had renormalized by then. The reasons for this require further investigation.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Urgencias Médicas/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Pandemias , Neumonía Viral/epidemiología , Alemania/epidemiología , Humanos
15.
Emerg Med J ; 37(12): 768-772, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-32988991

RESUMEN

BACKGROUND: The COVID-19 pandemic has stretched EDs globally, with many regions in England challenged by the number of COVID-19 presentations. In order to rapidly share learning to inform future practice, we undertook a thematic review of ED operational experience within England during the pandemic thus far. METHODS: A rapid phenomenological approach using semistructured telephone interviews with ED clinical leads from across England was undertaken between 16 and 22 April 2020. Participants were recruited through purposeful sampling with sample size determined by data saturation. Departments from a wide range of geographic distribution and COVID-19 experience were included. Themes were identified and included if they met one of three criteria: demonstrating a consistency of experience between EDs, demonstrating a conflict of approach between emergency departments or encapsulating a unique solution to a common barrier. RESULTS: Seven clinical leads from type 1 EDs were interviewed. Thematic redundancy was achieved by the sixth interview, and one further interview was performed to confirm. Themes emerged in five categories: departmental reconfiguration, clinical pathways, governance and communication, workforce and personal protective equipment. CONCLUSION: This paper summarises learning and innovation from a cross-section of EDs during the first UK wave of the COVID-19 pandemic. Common themes centred around the importance of flexibility when reacting to an ever-changing clinical challenge, clear leadership and robust methods of communication. Additionally, experience in managing winter pressures helped inform operational decisions, and ED staff demonstrated incredible resilience in demanding working conditions. Subsequent surges of COVID-19 infections may occur within a more challenging context with no guarantee that there will be an associated reduction in A&E attendance or cessation of elective activity. Future operational planning must therefore take this into consideration.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Planificación en Desastres , Medicina de Emergencia/organización & administración , Servicio de Urgencia en Hospital/organización & administración , Neumonía Viral/epidemiología , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/virología , Urgencias Médicas/epidemiología , Inglaterra/epidemiología , Humanos , Innovación Organizacional , Pandemias , Neumonía Viral/diagnóstico , Neumonía Viral/terapia , Neumonía Viral/virología , Investigación Cualitativa
16.
Rev. cuba. estomatol ; 57(3): e2891, jul.-set. 2020. tab, graf
Artículo en Portugués | LILACS, CUMED | ID: biblio-1126518

RESUMEN

RESUMO Introdução: Diversas situações no consultório odontológico podem gerar quadros de emergência. A administração de anestésicos locais, o atendimento odontológico aos pacientes com comprometimento sistêmico, ansiedade e medo são muitas vezes as causas mais comuns. Objetivo: O objetivo deste estudo foi avaliar o nível de percepção dos alunos de Odontologia frente às principais emergências odontológicas. Métodos: Tratou-se de um estudo transversal e descritivo com abordagem quantitativa dos dados por meio dos questionários. Foram entrevistados 138 alunos cursando do 5º ao 10º período de odontologia da Universidade Federal de Campina Grande, na cidade de Patos, Paraíba. Resultados: Foi observado que 86,2 porcento do total de entrevistados responderam saber a diferença entre urgência e emergência; 52,2 porcento dos alunos confirmaram receber ou terem recebido instruções extracurriculares sobre o assunto; 59,4 porcento responderam que o aprendizado fornecido na graduação sobre este tema não está sendo suficiente. Cerca de 17,4 porcento destes alunos responderam saber realizar as manobras de Reanimação Cardiopulmonar, 11,6 porcento dos entrevistados relataram que se sentiam preparados para lidar com uma situação de emergência e 81,9 porcento dos alunos pretendem buscar uma formação complementar durante ou após a graduação. Conclusão: Verificou-se que os alunos de graduação em odontologia apresentaram um baixo nível de percepção sobre as emergências médicas no consultório odontológico(AU)


RESUMEN Introducción: Varias situaciones en el consultorio dental pueden generar casos de emergencia. La administración de anestésicos locales, el cuidado dental a pacientes con deterioro sistémico, ansiedad y miedo, son a menudo las causas más comunes. Objetivo: Evaluar el nivel de percepción de los alumnos de odontología frente a las principales emergencias odontológicas. Métodos: Se trató de un estudio transversal y descriptivo de los datos por medio de los cuestionarios. Se entrevistaron 138 alumnos del 5.º al 10.º periodo de odontología de la Universidade Federal de Campina Grande, en la ciudad de Patos, Paraíba. Resultados: Se observó que el 86,2 por ciento del total de alumnos entrevistados sabían la diferencia entre urgencia y emergencia; 52,2 por ciento de los alumnos confirmaron recibir o haber recibido instrucciones extracurriculares sobre el asunto. El 59,4 por ciento respondió que el aprendizaje proporcionado en la graduación sobre este tema no está siendo suficiente. Alrededor del 17,4 por ciento de estos alumnos respondieron a saber realizar las maniobras de resucitación cardiopulmonar, 11,6 por ciento de los entrevistados se sentían preparados para lidiar con una situación de emergencia y el 81,9 por ciento de los alumnos entrevistados pretenden buscar una formación complementaria durante o después de la graduación. Conclusión: Se descubrió que los estudiantes de odontología tenían un bajo nivel de percepción sobre emergencias médicas en el consultorio odontológico(AU)


ABSTRACT Introduction: Several situations in the dental office may cause emergency cases. Administration of local anesthetics, dental care to patients with systemic deterioration, anxiety and fear are often the most common causes. Objective: To evaluate the dental level of perception of dental students facing the main dental emergencies. Methods: This was a cross-sectional and descriptive study of the data through questionnaires. We interviewed 138 students from the 5th to the 10th period of Dental Medicine at the Federal University of Campina Grande, in the city of Patos, Paraíba. Results: We observed that 86.2 percent of the interviewed students knew the difference between urgency and emergency; 52.2 percent of the students confirmed receiving or having received extracurricular instructions about the topic; 59.4 percent answered that the learning provided about this topic after graduation is not being sufficient. About 17.4 percent of these students responded positively to knowing how to perform cardiopulmonary resuscitation maneuvers; 11.6 percent of those interviewed felt themselves prepared to deal with an emergency situation, while 81.9 percent of the students interviewed intended to seek complementary training during or after graduation. Conclusion: Dental students were found to have a low level of perception about medical emergencies in the dental office(AU)


Asunto(s)
Humanos , Percepción , Estudiantes de Odontología , Identificación de la Emergencia , Urgencias Médicas/epidemiología , Epidemiología Descriptiva , Estudios Transversales , Atención Odontológica/métodos , Consultorios Odontológicos
19.
Clin Res Hepatol Gastroenterol ; 44(4): 579-585, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32788129

RESUMEN

BACKGROUND AND STUDY AIMS: The coronavirus 2019 (COVID-19) pandemic has significantly affected medical care. We surmise that the number of urgent endoscopies outside regular working hours in the Paris area decreased as a result. The objective of this study was to describe the observed number of acts during the 2020 mandatory period of home isolation, compared to the values in prior years and the expected value for 2020. MATERIAL AND METHODS: We performed a multicenter cohort study to investigate the practice of urgent endoscopy acts, outside regular working hours, in Paris and its surrounding suburbs, in the setting of the COVID-19 pandemic. We collected the number of endoscopies performed between January 17th and April 17th 2018, 2019 and 2020. We then collected clinical, endoscopic and outcome variables from the patients of years 2019 and 2020. RESULTS: From March 17th to April 17th (during home isolation), the number of acts was respectively of 147 in 2018, 137 in 2019, and 79 in 2020, lower that the expected number of 142 (-44.0%). In 2020, the number of endoscopies for suspected gastrointestinal bleeding (GIB), and findings of variceal and non-variceal bleeding decreased by 52.1%, 69.2% and 43.1% respectively, after a month of home isolation. In-hospital death rate were similar. CONCLUSIONS: This study confirms that the urgent endoscopy caseload outside regular hours decreased nearly by half during the pandemic. Our results suggest a decreased number of endoscopies for suspected gastrointestinal bleeding, and findings of variceal and non-variceal bleeding.


Asunto(s)
Atención Posterior/estadística & datos numéricos , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Urgencias Médicas/epidemiología , Endoscopía/estadística & datos numéricos , Neumonía Viral/epidemiología , Estudios de Cohortes , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Paris/epidemiología , Factores de Tiempo
20.
PLoS One ; 15(8): e0237751, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32817673

RESUMEN

BACKGROUND: In the developed world, cardiovascular diseases still contribute to mortality and morbidity, leading to significantly increased deaths in recent years. Thus, it is necessary for a layperson to provide the best possible basic life support (BLS) until professional help is available. Since information on current BLS knowledge in Germany is not available, but necessary to be able to make targeted improvements in BLS education, we conducted this study. METHODS: A cohort survey using convenience sampling (non-probability) method was conducted with questions found in emergency medicine education. People coming to the emergency room of two big university hospitals located in the South (Munich) and western part (Cologne) of Germany were asked to participate in the survey between 2016 and 2017. Primary outcome measures were the proportion of correct answers for each emergency scenario in relationship to age, region, profession and first-aid training. RESULTS: Altogether 1003 people (504 from Cologne; 499 from Munich) took part in the questionnaire. 54.7% were female and 45.3% were male aging from 19 to 52 with a mean of 37.2 years. Although over 90% had taken part in first aid training, many people were lacking first aid knowledge, with less than 10% choosing the correct frequency for chest compression. Hereby demographic factors had a significant influence (p<0.05) in the given answers (Friedmann-and-Wilcoxon Test). CONCLUSION: Overall, results of our survey indicate a clear lack of BLS knowledge. With this information, targeted measures for improving BLS knowledge should be conducted. Additionally, further studies on the feasibility and efficiency of teaching methods are needed.


Asunto(s)
Reanimación Cardiopulmonar/métodos , Enfermedades Cardiovasculares/prevención & control , Urgencias Médicas/epidemiología , Medicina de Emergencia/normas , Adulto , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/patología , Femenino , Alemania/epidemiología , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
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