Effectiveness of telemedicine in response to the COVID-19 pandemic

SUMMARY OBJECTIVE: The aim of this study was to evaluate the utility of the telemedicine care model implemented to treat and guide patients with COVID-19 related symptoms and indicators during the pandemic. METHODS: This is a retrospective study with data collected from the electronic records of standardized forms for assistance. As a way of evaluating the work performed, the number of consultations, types of referrals, efficiency of care, and patient satisfaction were observed. RESULTS: Between April 2 and October 15, 2020, 92 professionals attended 3,660 patients by telemedicine; out of them, 523 (14.3%) were referred to a COVID-19 attending room, 128 (3.5%) to other specialties, 123 (3.4%) to a general emergency department, and 2,886 (78.9%) were monitored via home care. Of the total number of patients, 81 (2.2%) were hospitalized, and 13 (0.35%) died. CONCLUSION: Telemedicine offered useful tools for the care, treatment, and monitoring of patients with COVID-19 during the pandemic. The service was considered by most respondents as satisfactory, resolutive, or safe.

Effectiveness of telemedicine in response to the COVID-19 pandemic.

OBJECTIVE: The aim of this study was to evaluate the utility of the telemedicine care model implemented to treat and guide patients with COVID-19 related symptoms and indicators during the pandemic. METHODS: This is a retrospective study with data collected from the electronic records of standardized forms for assistance. As a way of evaluating the work performed, the number of consultations, types of referrals, efficiency of care, and patient satisfaction were observed. RESULTS: Between April 2 and October 15, 2020, 92 professionals attended 3,660 patients by telemedicine; out of them, 523 (14.3%) were referred to a COVID-19 attending room, 128 (3.5%) to other specialties, 123 (3.4%) to a general emergency department, and 2,886 (78.9%) were monitored via home care. Of the total number of patients, 81 (2.2%) were hospitalized, and 13 (0.35%) died. CONCLUSION: Telemedicine offered useful tools for the care, treatment, and monitoring of patients with COVID-19 during the pandemic. The service was considered by most respondents as satisfactory, resolutive, or safe.

Coma metabólico / Methabolic coma

Coma pode ser definido como um estado de não-responsividade e não-reatividade do organismo, e o seu diagnóstico é feito quando temos uma Escala de Coma de Glasgow menor ou igual a 7. De acordo com a literatura médica, aproximadamente 60 por cento dos casos de coma têm origem em desordens metabólicas, que levam a alterações no suprimento de metabólitos ou modificações da excitabilidade neuronal.

Alteraçöes na expressäo do antígeno nuclear de proliferaçäo celular e dos receptores de estrogênio e de progesterona provocadas pela quimioterapia primária no carcinoma de mama / Assessment of proliferating cells of nuclear antigen and estrogen and progesterone receptor expression changes determined by primary chemotherapy in breast cancer

OBJETIVO: averiguar as alteraçöes induzidas pela quimioterapia primária no fenótipo celular. MÉTODOS: avaliamos a expressäo do antígeno nuclear de proliferaçäo celular (PCNA) e dos receptores de estrogênio (RE) e de progesterona (RP) em 17 tumores de mama no estádio clínico II, obtidos antes e após a terapia antiblástica, por método imuno-histoquímico. Os valores foram relacionados com o estado menstrual, com a resposta clínica tumoral e com o comprometimento axilar. RESULTADOS: houve reduçäo significante na porcentagem de células coradas pelo anti-PCNA antes (tempo A) e após (tempo B) a quimioterapia (p=0,041). Observamos também resultados significantes ao compararmos os índices médios de PCNA com o grau histológico GII/GIII [tempo A=63,1 e tempo B=38,7 (p=0,049)] e nos casos em que houve resposta clínica [tempo A=53,1 e tempo B=34,4 (p=0,011)]. Näo observamos relaçäo significante entre os índices de PCNA com o estado menstrual e o axilar. Houve reduçäo significante do RE após a quimioterapia nas pacientes pré-menopausadas [tempo A=60,3 e tempo B=24,1 (p=0,027)] e naquelas que apresentaram resposta clínica ao tratamento [tempo A=59,1 e tempo B=37,9 (p=0,030)]. Observamos aumento significante do RP após a quimioterapia nas pacientes pós-menopausadas [tempo A=35,3 e tempo B=58,3 (p=0,023)]. Näo encontramos relaçäo entre os receptores hormonais e o comprometimento axilar. CONCLUSÖES: a diminuiçäo dos índices de PCNA nos tumores de alto grau histológico, do RE nas pacientes pré-menopausadas e de ambos, PCNA e RE, nos tumores com reduçäo clínica após a quimioterapia nos mostra que ela atuou sobre as células em proliferaçäo e que o PCNA pode ser utilizado como parâmetro de resposta a este tratamento