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1.
Epidemiol Infect ; 149: e9, 2020 12 28.
Artigo em Inglês | MEDLINE | ID: mdl-33436132

RESUMO

Amplifying the testing capacity and making better use of testing resources is a crucial measure when fighting any pandemic. A pooled testing strategy for SARS-CoV-2 has theoretically been shown to increase the testing capacity of a country, especially when applied in low prevalence settings. Experimental studies have shown that the sensitivity of reverse transcription-polymerase chain reaction is not affected when implemented in small groups. Previous models estimated the optimum group size as a function of the historical prevalence; however, this implies a homogeneous distribution of the disease within the population. This study aimed to explore whether separating individuals by age groups when pooling samples results in any further savings on test kits or affects the optimum group size estimation compared to Dorfman's pooling, based on historical prevalence. For this evaluation, age groups of interest were defined as 0-19 years, 20-59 years and over 60 years old. Generalisation of Dorfman's pooling was performed by adding statistical weight to the age groups based on the number of confirmed cases and tests performed in the segment. The findings showed that when the pooling samples are based on age groups, there is a decrease in the number of tests per subject needed to diagnose one subject. Although this decrease is minuscule, it might account for considerable savings when applied on a large scale. In addition, the savings are considerably higher in settings where there is a high standard deviation among the positivity rate of the age segments of the general population.


Assuntos
/métodos , /diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Humanos , Lactente , Recém-Nascido , Pessoa de Meia-Idade , Modelos Estatísticos , Adulto Jovem
2.
Rev. chil. pediatr ; 87(2): 116-120, abr. 2016. ilus
Artigo em Espanhol | LILACS-Express | LILACS | ID: lil-783493

RESUMO

Resumen Los cuidados intensivos pediátricos son una especialidad nueva, con importantes avances tecnológicos que pueden prolongar el proceso de morir. Uno de los problemas bioéticos frecuentes es la limitación del esfuerzo terapéutico, que es la adecuación y/o proporcionalidad del tratamiento tratando de evitar obstinación y futilidad. Objetivo Conocer la experiencia de médicos que trabajan en unidades de cuidado intensivo (UCIP) ante decisiones ético-clínicas. Sujetos y método Estudio observacional, descriptivo y transversal, aplicando una encuesta anónima a médicos de UCIP, solicitando datos sobre problemas éticos que se generan en la atención al niño crítico y su procedimiento de resolución. Aprobado por el Comité de Ética de la Investigación de la Facultad de Medicina de la Universidad del Desarrollo-Clínica Alemana. Resultados Respondieron 126 médicos de 34 UCIP de Chile. El 98,41% ha tomado decisiones de limitación terapéutica. El tipo de limitación más frecuente mencionado fue la orden de no reanimar (n = 119), seguido por la no instauración de medicamentos (n = 113), limitación de ingreso a UCIP (n = 81), siendo la menos mencionada la retirada de tratamientos (n = 81). El 34,13% consideró que existían diferencias éticas entre no instaurar o retirar un determinado tratamiento. Conclusiones Los dilemas ético-clínicos son comunes en la UCIP, siendo frecuentes las decisiones de limitación terapéutica. Muchos médicos reconocen no poseer conocimientos en ética clínica y necesitar formación continua en bioética.


Abstract Paediatric intensive care is a relatively new specialty, with significant technological advances that lead to the prolongation of the dying process. One of the most common bioethical problems is limitation of treatment, which is the adequacy and/or proportionality treatment, trying to avoid obstinacy and futility. Objective To determine the experience of physicians working in Paediatric Intensive Care Units (PICU) when faced with bioethical decisions. Subjects and method An observational, descriptive and cross-sectional study was conducted using an anonymous questionnaire sent to physicians working in PICU. The data requested was related to potential ethical problems generated in the care of the critical child, and the procedure for their resolution. The study was approved by the Ethics Research Committee of the Faculty of Medicine UDD CAS. Results A total of 126 completed questionnaires were received from physicians working in 34 PICU in Chile. Almost all (98.41%) of them acknowledged having taken therapeutic limitation decisions (TLD). The most common type of TLD mentioned was the Do Not Resuscitate order (n = 119), followed by the establishment of no medications (n = 113), limited admission to PICU (n = 81), with the withdrawal of treatment being the least mentioned (n = 81). Around one-third (34.13%) felt that there were no ethical difference between introducing or removing certain treatments. Conclusions Bioethical dilemmas are common in the PICU, with therapeutic limitation decisions being frequent. Many recognise not having expertise in clinical ethics, and they need continuing education in bioethics.

3.
Rev Chil Pediatr ; 87(2): 116-20, 2016.
Artigo em Espanhol | MEDLINE | ID: mdl-26787502

RESUMO

UNLABELLED: Paediatric intensive care is a relatively new specialty, with significant technological advances that lead to the prolongation of the dying process. One of the most common bioethical problems is limitation of treatment, which is the adequacy and/or proportionality treatment, trying to avoid obstinacy and futility. OBJECTIVE: To determine the experience of physicians working in Paediatric Intensive Care Units (PICU) when faced with bioethical decisions. SUBJECTS AND METHOD: An observational, descriptive and cross-sectional study was conducted using an anonymous questionnaire sent to physicians working in PICU. The data requested was related to potential ethical problems generated in the care of the critical child, and the procedure for their resolution. The study was approved by the Ethics Research Committee of the Faculty of Medicine UDD CAS. RESULTS: A total of 126 completed questionnaires were received from physicians working in 34 PICU in Chile. Almost all (98.41%) of them acknowledged having taken therapeutic limitation decisions (TLD). The most common type of TLD mentioned was the Do Not Resuscitate order (n=119), followed by the establishment of no medications (n=113), limited admission to PICU (n=81), with the withdrawal of treatment being the least mentioned (n=81). Around one-third (34.13%) felt that there were no ethical difference between introducing or removing certain treatments. CONCLUSIONS: Bioethical dilemmas are common in the PICU, with therapeutic limitation decisions being frequent. Many recognise not having expertise in clinical ethics, and they need continuing education in bioethics.


Assuntos
Temas Bioéticos , Conhecimentos, Atitudes e Prática em Saúde , Assistência Terminal/ética , Suspensão de Tratamento/ética , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Tomada de Decisões/ética , Feminino , Humanos , Unidades de Terapia Intensiva Pediátrica , Masculino , Pessoa de Meia-Idade , Pediatria/ética , Médicos/ética , Ordens quanto à Conduta (Ética Médica)/ética , Inquéritos e Questionários
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