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1.
Heart Fail Clin ; 16(4): 433-440, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32888638

RESUMO

Despite steady progress over the past 3 decades in advancing drug and device therapies to reduce morbidity and mortality in heart failure with reduced ejection fraction, large registries of usual care demonstrate incomplete use of these evidence-based therapies in clinical practice. Potential strategies to improve guideline-directed medical therapy include leveraging non-physician clinicians, solidifying transitions of care, incorporating telehealth solutions, and engaging in comprehensive comorbid disease management via multidisciplinary team structures. These approaches may be particularly relevant in an era of Coronavirus Disease 2019 and associated need for social distancing, further limiting contact with traditional ambulatory clinic settings.


Assuntos
Assistência Ambulatorial , Infecções por Coronavirus , Insuficiência Cardíaca/terapia , Pandemias , Pneumonia Viral , Assistência Ambulatorial/métodos , Assistência Ambulatorial/organização & administração , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Insuficiência Cardíaca/epidemiologia , Humanos , Inovação Organizacional , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle
3.
Infez Med ; 28(3): 351-356, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32920570

RESUMO

The rapidly increased number of patients with COVID-19 resulted in the shortage of hospital beds. An outpatient follow-up plan was developed for COVID-19 patients with stable clinical condition and no concomitant diseases. The records of COVID-19 first admission clinic were retrospectively reviewed to identify the COVID-19 patients who were followed on home isolation as outpatients between March 17, 2020 and April 18, 2020 in Ankara, Turkey. Demographic and clinical characteristics of the patients, compliance with isolation rules, re-admission rates, and outcomes were investigated. A total of 41 patients with COVID-19 were followed on home isolation without hospitalization. The median age of the patients was 36 years. Twenty-four (58.5%) of 41 patients were female. Twenty-nine (70.7%) patients were healthcare workers. The most common symptoms at admission were cough, myalgia/arthralgia, and loss of smell and/or taste. Fourteen (34.1%) patients were asymptomatic on the first admission. Anti-viral treatment was given to 27 (65.8%) of 41 patients. Four of 41 patients were readmitted to the outpatient clinic and hospitalized. Three patients had worsening respiratory symptoms and pneumonia was detected in CT scans. One patient was hospitalized because of disseminated herpes zoster infection. Two patients who jeopardized the isolation rules were isolated and monitored at another hospital by provincial health directorate teams. If adequate conditions are provided, follow-up on home isolation seems to be a feasible method in carefully selected patients. However, these patients should be monitored closely by an experienced team during the isolation period.


Assuntos
Assistência Ambulatorial/métodos , Antivirais/uso terapêutico , Betacoronavirus , Infecções por Coronavirus/tratamento farmacológico , Isolamento de Pacientes/métodos , Pneumonia Viral/tratamento farmacológico , Adulto , Ocupação de Leitos , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Feminino , Pessoal de Saúde/estatística & dados numéricos , Humanos , Masculino , Doenças Profissionais/diagnóstico , Doenças Profissionais/tratamento farmacológico , Doenças Profissionais/epidemiologia , Pacientes Ambulatoriais , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Estudos Retrospectivos , Avaliação de Sintomas , Turquia/epidemiologia
6.
BMC Infect Dis ; 20(1): 596, 2020 Aug 12.
Artigo em Inglês | MEDLINE | ID: mdl-32787859

RESUMO

BACKGROUND: Group A Rotavirus (RVA), despite being an important pathogen in hospitalized children, is less studied in pediatric outpatients, and even rarely investigated in adults. This study aims to understand the genetic diversity of RVA in outpatients across all age groups in Shanghai, and thus providing a molecular basis for vaccine implementation and evaluation. METHODS: Stool samples were first screened by Real-time Reverse Transcription Polymerase Chain Reaction (rRT-PCR). RVA genotyping was performed through the amplification of partial VP7 and VP4 gene. Strains of interest were further sequenced and analyzed using MEGA 6.0. RESULTS: Four thousand nine hundred one samples were collected, from which 7.61% (373 cases) were screened positive for RVA. RVA prevalence was higher in children (9.30%) than in adults (7.21%) (χ2 = 4.72, P < 0.05). 9.38% RVA positive cases had taken antibiotics before hospital visit while 49.60% had been prescribed antibiotics afterwards. RVA displayed a strong seasonality in both adults and children with a shared commonality in genotype repertoire, where G9P[8] was the most prevalent strain (67.96%) followed by G3P[8] (15.49%) and G1P[8] (12.32%). Meanwhile the first local case of fecal shedding of the G10P[15] vaccine strain was also discovered. CONCLUSIONS: While the prevalence of rotavirus is highest during cold seasons, it is revealed for the first time that G9P[8] is the predominant genotype in both adults and pediatric outpatients. Clinically, higher occurrence of nausea or vomiting was observed in RVA positive cases. Antibiotic overuse was implicated in both non-clinical and clinical settings. The finding emphasizes the importance of RVA genotyping in surveillance as it provides the basis for new vaccine application as well as a baseline for future vaccine efficacy evaluation.


Assuntos
Assistência Ambulatorial/métodos , Gastroenterite/epidemiologia , Gastroenterite/virologia , Variação Genética , Infecções por Rotavirus/epidemiologia , Rotavirus/genética , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , China/epidemiologia , Fezes/virologia , Feminino , Genótipo , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Filogenia , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Rotavirus/imunologia , Infecções por Rotavirus/virologia , Vacinas contra Rotavirus/imunologia , Estações do Ano , Adulto Jovem
7.
Clin Appl Thromb Hemost ; 26: 1076029620947476, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32822220

RESUMO

The coronavirus disease of 2019 (COVID-19) has posed a major challenge for providers and patients. A large number of patients with atrial fibrillation, venous thromboembolism, or valvular heart disease are chronically anticoagulated with vitamin K antagonists and rely on frequent follow ups at anticoagulation clinics for management of their anticoagulation therapy. The need for isolation during COVID-19 pandemic can potentially limit access to health care including anticoagulation clinics and directly affect the care of patients on chronic anticoagulation. Therefore, we created a drive-through clinic to bridge the gap of continuation of care and preservation of social distancing precautions. In this manuscript, we report the steps in implementing such initiative which can be applied to other clinics during a pandemic.


Assuntos
Anticoagulantes/administração & dosagem , Transtornos da Coagulação Sanguínea/tratamento farmacológico , Transtornos da Coagulação Sanguínea/epidemiologia , Infecções por Coronavirus/epidemiologia , Controle de Infecções/organização & administração , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Assistência Ambulatorial/métodos , Instituições de Assistência Ambulatorial/organização & administração , Transtornos da Coagulação Sanguínea/diagnóstico , Comorbidade , Infecções por Coronavirus/prevenção & controle , Feminino , Seguimentos , Humanos , Illinois , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Melhoria de Qualidade , Medição de Risco , Gestão da Segurança , Resultado do Tratamento
9.
Cochrane Database Syst Rev ; 8: CD007372, 2020 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-32852803

RESUMO

BACKGROUND: The setting in which induction of labour takes place (home or inpatient) is likely to have implications for safety, women's experiences and costs. Home induction may be started at home with the subsequent active phase of labour happening either at home or in a healthcare facility (hospital, birth centre, midwifery-led unit). More commonly, home induction starts in a healthcare facility, then the woman goes home to await the start of labour. Inpatient induction takes place in a healthcare facility where the woman stays while awaiting the start of labour. OBJECTIVES: To assess the effects on neonatal and maternal outcomes of third trimester home induction of labour compared with inpatient induction using the same method of induction. SEARCH METHODS: For this update, we searched the Cochrane Pregnancy and Childbirth Group's Trials Register, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform (ICTRP) (31 January 2020)), and reference lists of retrieved studies. SELECTION CRITERIA: Published and unpublished randomised controlled trials (RCTs) in which home and inpatient settings for induction have been compared. We included conference abstracts but excluded quasi-randomised trials and cross-over studies. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed study reports for inclusion. Two review authors carried out data extraction and assessment of risk of bias independently. GRADE assessments were checked by a third review author. MAIN RESULTS: We included seven RCTs, six of which provided data on 1610 women and their babies. Studies were undertaken between 1998 and 2015, and all were in high- or upper-middle income countries. Most women were induced for post dates. Three studies reported government funding, one reported no funding and three did not report on their funding source. Most GRADE assessments gave very low-certainty evidence, downgrading mostly for high risk of bias and serious imprecision. 1. Home compared to inpatient induction with vaginal prostaglandin E (PGE) (two RCTs, 1028 women and babies; 1022 providing data). Although women's satisfaction may be slightly better in home settings, the evidence is very uncertain (mean difference (MD) 0.16, 95% confidence interval (CI) -0.02 to 0.34, 1 study, 399 women), very low-certainty evidence. There may be little or no difference between home and inpatient induction for other primary outcomes, with all evidence being very low certainty: - spontaneous vaginal birth (average risk ratio (RR) [aRR] 0.91, 95% CI 0.69 to 1.21, 2 studies, 1022 women, random-effects method); - uterine hyperstimulation (RR 1.19, 95% CI 0.40 to 3.50, 1 study, 821 women); - caesarean birth (RR 1.01, 95% CI 0.81 to 1.28, 2 studies, 1022 women); - neonatal infection (RR 1.29, 95% CI 0.59 to 2.82, 1 study, 821 babies); - admission to neonatal intensive care unit (NICU) (RR 1.20, 95% CI 0.50 to 2.90, 2 studies, 1022 babies). Studies did not report serious neonatal morbidity or mortality. 2. Home compared to inpatient induction with controlled release PGE (one RCT, 299 women and babies providing data). There was no information on whether the questionnaire on women's satisfaction with care used a validated instrument, but the findings presented showed no overall difference in scores. We found little or no difference between the groups for other primary outcomes, all also being very low-certainty evidence: - spontaneous vaginal birth (RR 0.94, 95% CI 0.77 to 1.14, 1 study, 299 women); - uterine hyperstimulation (RR 1.01, 95% CI 0.51 to 1.98, 1 study, 299 women); - caesarean births (RR 0.95, 95% CI 0.64 to 1.42, 1 study, 299 women); - admission to NICU (RR 1.38, 0.57 to 3.34, 1 study, 299 babies). The study did not report on neonatal infection nor serious neonatal morbidity or mortality. 3. Home compared to inpatient induction with balloon or Foley catheter (four RCTs; three studies, 289 women and babies providing data). It was again unclear whether questionnaires reporting women's experiences/satisfaction with care were validated instruments, with one study (48 women, 69% response rate) finding women were similarly satisfied. Home inductions may reduce the number of caesarean births, but the data are also compatible with a slight increase and are of very low-certainty (RR 0.64, 95% CI 0.41 to 1.01, 2 studies, 159 women). There was little or no difference between the groups for other primary outcomes with all being very low-certainty evidence: - spontaneous vaginal birth (RR 1.04, 95% CI 0.54 to 1.98, 1 study, 48 women): - uterine hyperstimulation (RR 0.45, 95% CI 0.03 to 6.79, 1 study, 48 women); - admission to NICU (RR 0.37, 95% CI 0.07 to 1.86, 2 studies, 159 babies). There were no serious neonatal infections nor serious neonatal morbidity or mortality in the one study (involving 48 babies) assessing these outcomes. AUTHORS' CONCLUSIONS: Data on the effectiveness, safety and women's experiences of home versus inpatient induction of labour are limited and of very low-certainty. Given that serious adverse events are likely to be extremely rare, the safety data are more likely to come from very large observational cohort studies rather than relatively small RCTs.


Assuntos
Assistência Ambulatorial/métodos , Maturidade Cervical , Hospitalização , Trabalho de Parto Induzido/métodos , Cateterismo/métodos , Cesárea/estatística & dados numéricos , Preparações de Ação Retardada , Dinoprostona , Feminino , Humanos , Recém-Nascido , Tempo de Internação , Ocitócicos , Segurança do Paciente , Satisfação do Paciente , Gravidez , Resultado da Gravidez , Ensaios Clínicos Controlados Aleatórios como Assunto
10.
Curr Oncol ; 27(3): e332-e335, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32669941

RESUMO

The emergence of the covid-19 disease pandemic caused by the 2019 novel coronavirus has required a re-evaluation of treatment practices for clinicians caring for patients with chronic lymphocytic leukemia (cll). The American Society for Hematology (ash) has provided a series of recommendations for the treatment of patients with cll during the pandemic, covering a range of topics, including testing for covid-19, cll treatment initiation and selection, use of immunoglobulin therapy, in-person monitoring, and treatment of patients with cll and covid-19. We summarize the ash recommendations and discuss their applicability as guidelines for the treatment of cll during the covid-19 pandemic in Canada.


Assuntos
Antineoplásicos/uso terapêutico , Infecções por Coronavirus/epidemiologia , Fatores Imunológicos/uso terapêutico , Leucemia Linfocítica Crônica de Células B/terapia , Pneumonia Viral/epidemiologia , Assistência Ambulatorial/métodos , Agendamento de Consultas , Betacoronavirus , Canadá/epidemiologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Gerenciamento Clínico , Hospitalização , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Leucemia Linfocítica Crônica de Células B/complicações , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Guias de Prática Clínica como Assunto , Pirazóis/uso terapêutico , Pirimidinas/uso terapêutico
11.
Am J Hosp Palliat Care ; 37(11): 985-987, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32720520

RESUMO

CONTEXT: The coronavirus disease 2019 (COVID-19) pandemic laid bare the immediate need for primary palliative care education for many clinicians. Primary care clinicians in our health system reported an urgent need for support in advance care planning and end-of-life symptom management for their vulnerable patients. This article describes the design and dissemination of palliative care education for primary care clinicians using an established curriculum development method. OBJECTIVES: To develop a succinct and practical palliative care toolkit for use by primary care clinicians during the COVID-19 pandemic, focused on 2 key elements: (i) advance care planning communication skills based on the narrative 3-Act Model and (ii) comfort care symptom management at the end of life. RESULTS: The toolkit was finalized through an iterative process involving a team of end-users and experts in palliative care and primary care, including social work, pharmacy, nursing, and medicine. The modules were formatted into an easily navigable, smartphone-friendly document to be used at point of care. The toolkit was disseminated to our institution's primary care network with practices spanning our state. Early feedback has been positive. CONCLUSION: While we had been focused primarily on the inpatient setting, our palliative care team at Johns Hopkins Bayview Medical Center pivoted existing infrastructure and curriculum development expertise to meet the expressed needs of our primary care colleagues during the COVID-19 pandemic. Through collaboration with an interprofessional team including end-users, we designed and disseminated a concise palliative care toolkit within 6 weeks.


Assuntos
Assistência Ambulatorial/métodos , Betacoronavirus , Infecções por Coronavirus/terapia , Cuidados Paliativos/métodos , Pandemias , Pneumonia Viral/terapia , Planejamento Antecipado de Cuidados , Comunicação , Humanos
13.
JCO Glob Oncol ; 6: 1046-1051, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32639877

RESUMO

PURPOSE: Many patients with cancer, often those with rare cancers such as sarcomas, travel long distances to access expert care. The COVID-19 pandemic necessitated widespread changes in delivery of cancer care, including rapid adoption of telemedicine-based care. We aimed to evaluate the impact of telemedicine on patients, clinicians, and care delivery at the Royal Marsden Hospital (RMH) Sarcoma Unit during the pandemic. METHODS: Data were extracted from patient records for all planned outpatient appointments at the RMH Sarcoma Unit from March 23 to April 24, 2020. Patients and clinicians completed separate questionnaires to understand their experiences. RESULTS: Of 379 planned face-to-face appointments, 283 (75%) were converted to telemedicine. Face-to-face appointments remained for patients who needed urgent start of therapy or performance status assessment. Patients lived on average > 1.5 hours from RMH. Patient satisfaction (n = 108) with telemedicine was high (mean, 9/10), and only 48% (n = 52/108) would not want to hear bad news using telemedicine. Clinicians found telemedicine efficient, with no associated increased workload, compared with face-to-face appointments. Clinicians indicated lack of physical examination did not often affect care provision when using telemedicine. Most clinicians (n = 17; 94%) believed telemedicine use was practice changing; congruently, 80% (n = 86/108) of patients desired some telemedicine as part of their future care, citing reduced cost and travel time. CONCLUSION: Telemedicine can revolutionize delivery of cancer care, particularly for patients with rare cancers who often live far away from expert centers. Our study demonstrates important patient and clinician benefits; assessment of longer-term impact on patient outcomes and health care systems is needed.


Assuntos
Assistência Ambulatorial/métodos , Infecções por Coronavirus/epidemiologia , Oncologia/métodos , Pandemias , Satisfação do Paciente , Pneumonia Viral/epidemiologia , Sarcoma/terapia , Telemedicina/métodos , Carga de Trabalho , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Assistência à Saúde/métodos , Feminino , Neoplasias Gastrointestinais/terapia , Tumores do Estroma Gastrointestinal/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias de Tecidos Moles/terapia , Viagem , Reino Unido/epidemiologia , Adulto Jovem
14.
Am J Infect Control ; 48(9): 1087-1089, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32621858

RESUMO

COVID-19 pandemic turned the entire health-care system organization upside-down, suspending elective activities and outpatient services. In Italy, we are entering a second phase of the pandemic and several strategies have been developed to "re-open" the country, some businesses, and also health care outpatient activities. This manuscript describes the experience of a Southern Italy Respiratory Unit for safely resuming outpatient respiratory services and preventing COVID-19 transmission.


Assuntos
Assistência Ambulatorial/métodos , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Terapia Respiratória/métodos , Infecções por Coronavirus/transmissão , Humanos , Itália , Pneumonia Viral/transmissão , Testes de Função Respiratória/métodos
16.
PLoS One ; 15(7): e0235605, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32628707

RESUMO

INTRODUCTION: Paediatric consultations form a significant proportion of all consultations in ambulatory care. Point-of-care tests (POCTs) may offer a potential solution to improve clinical outcomes for children by reducing diagnostic uncertainty in acute illness, and streamlining management of chronic diseases. However, their clinical impact in paediatric ambulatory care is unknown. We aimed to describe the clinical impact of all in-vitro diagnostic POCTs on patient outcomes and healthcare processes in paediatric ambulatory care. METHODS: We searched MEDLINE, EMBASE, Pubmed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Web of Science from inception to 29 January 2020 without language restrictions. We included studies of children presenting to ambulatory care settings (general practice, hospital outpatient clinics, or emergency departments, walk-in centres, registered drug shops delivering healthcare) where in-vitro diagnostic POCTs were compared to usual care. We included all quantitative clinical outcome data across all conditions or infection syndromes reporting on the impact of POCTs on clinical care and healthcare processes. Where feasible, we calculated risk ratios (RR) with 95% confidence intervals (CI) by performing meta-analysis using random effects models. RESULTS: We included 35 studies. Data relating to at least one outcome were available for 89,439 children of whom 45,283 had a POCT across six conditions or infection syndromes: malaria (n = 14); non-specific acute fever 'illness' (n = 7); sore throat (n = 5); acute respiratory tract infections (n = 5); HIV (n = 3); and diabetes (n = 1). Outcomes centred around decision-making such as prescription of medications or hospital referral. Pooled estimates showed that malarial-POCTs (Plasmodium falciparum) better targeted antimalarial treatment by reducing over-treatment by a third compared to usual care (RR 0.67; 95% CI [0.58 to 0.77], n = 36,949). HIV-POCTs improved initiating earlier antiretroviral therapy compared to usual care (RR, 3.11; 95% CI [1.55 to 6.25], n = 912). Across the other four conditions, there was limited evidence for the benefit of POCTs in paediatric ambulatory care except for acute respiratory tract infections (RTI) in low-and-middle-income countries (LMICs), where POCT C-Reactive Protein (CRP) may reduce immediate antibiotic prescribing by a third (risk difference, -0.29 [-0.47, -0.11], n = 2,747). This difference was shown in randomised controlled trials in LMICs which included guidance on interpretation of POCT-CRP, specific training or employed a diagnostic algorithm prior to POC testing. CONCLUSION: Overall, there is a paucity of evidence for the use of POCTs in paediatric ambulatory care. POCTs help to target prescribing for children with malaria and HIV. There is emerging evidence that POCT-CRP may better target antibiotic prescribing for children with acute RTIs in LMIC, but not in high-income countries. Research is urgently needed to understand where POCTs are likely to improve clinical outcomes in paediatric settings worldwide.


Assuntos
Assistência Ambulatorial/métodos , Pediatria/métodos , Testes Imediatos , Humanos
17.
Arch Cardiol Mex ; 90(Supl): 77-83, 2020.
Artigo em Inglês | MEDLINE | ID: covidwho-595195

RESUMO

A review is carried out to examine the risk of patients suffering from diabetes mellitus in the context of general morbidity and mortality and related to infection by SARS-CoV-2. Likewise, the general recommendations for food and the prevention of comorbidities that most these patients suffer most frequently are also studied. Finally, a review of the pharmacological recommendations on both oral and parenteral treatment in the outpatient, in hospitalization and in critical states infected with SARS-CoV-2 is made.


Assuntos
Doenças Cardiovasculares/terapia , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus/terapia , Pneumonia Viral/epidemiologia , Assistência Ambulatorial/métodos , Betacoronavirus , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/virologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/terapia , Estado Terminal , Diabetes Mellitus/mortalidade , Diabetes Mellitus/virologia , Hospitalização , Humanos , Pandemias , Pneumonia Viral/mortalidade , Pneumonia Viral/terapia , Fatores de Risco
18.
J Pak Med Assoc ; 70(Suppl 3)(5): S52-S55, 2020 May.
Artigo em Inglês | MEDLINE | ID: covidwho-592824

RESUMO

In a brief span of a few months, coronavirus disease (COVID-19) pandemic has brought a major paradigm shift in operation of clinical services around the world. Infection may be mild, moderate or severe; many remain asymptomatic. High burden of non-communicable and communicable diseases theoretically puts Pakistani population at increased risk of severe COVID-19 infection. Considering the universal risk of infection, the outpatient services in Pakistan need to be redesigned. Starting with risk assessment of the facility and provision of a dedicated telephone connection, structure and workflow need to be redesigned in order to minimise risk of exposure to healthcare professionals, staff and patients. Patients with COVID-19 patients should be identified before they arrive in the facility and should be served expeditiously, in an environment which prevents cross-transmission of infection. Tele-consultation is assuming an important role. Changes which are taking place in response to Covid-19 pandemic will have far reaching effects on clinical services in Pakistan.


Assuntos
Assistência Ambulatorial , Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Assistência Ambulatorial/métodos , Assistência Ambulatorial/normas , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Assistência à Saúde/métodos , Assistência à Saúde/normas , Humanos , Paquistão , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Consulta Remota , Medição de Risco
19.
J Pak Med Assoc ; 70(Suppl 3)(5): S52-S55, 2020 May.
Artigo em Inglês | MEDLINE | ID: covidwho-609378

RESUMO

In a brief span of a few months, coronavirus disease (COVID-19) pandemic has brought a major paradigm shift in operation of clinical services around the world. Infection may be mild, moderate or severe; many remain asymptomatic. High burden of non-communicable and communicable diseases theoretically puts Pakistani population at increased risk of severe COVID-19 infection. Considering the universal risk of infection, the outpatient services in Pakistan need to be redesigned. Starting with risk assessment of the facility and provision of a dedicated telephone connection, structure and workflow need to be redesigned in order to minimise risk of exposure to healthcare professionals, staff and patients. Patients with COVID-19 patients should be identified before they arrive in the facility and should be served expeditiously, in an environment which prevents cross-transmission of infection. Tele-consultation is assuming an important role. Changes which are taking place in response to Covid-19 pandemic will have far reaching effects on clinical services in Pakistan.


Assuntos
Assistência Ambulatorial , Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Assistência Ambulatorial/métodos , Assistência Ambulatorial/normas , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Assistência à Saúde/métodos , Assistência à Saúde/normas , Humanos , Paquistão , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Consulta Remota , Medição de Risco
20.
J Pak Med Assoc ; 70(Suppl 3)(5): S52-S55, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32515378

RESUMO

In a brief span of a few months, coronavirus disease (COVID-19) pandemic has brought a major paradigm shift in operation of clinical services around the world. Infection may be mild, moderate or severe; many remain asymptomatic. High burden of non-communicable and communicable diseases theoretically puts Pakistani population at increased risk of severe COVID-19 infection. Considering the universal risk of infection, the outpatient services in Pakistan need to be redesigned. Starting with risk assessment of the facility and provision of a dedicated telephone connection, structure and workflow need to be redesigned in order to minimise risk of exposure to healthcare professionals, staff and patients. Patients with COVID-19 patients should be identified before they arrive in the facility and should be served expeditiously, in an environment which prevents cross-transmission of infection. Tele-consultation is assuming an important role. Changes which are taking place in response to Covid-19 pandemic will have far reaching effects on clinical services in Pakistan.


Assuntos
Assistência Ambulatorial , Betacoronavirus , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Assistência Ambulatorial/métodos , Assistência Ambulatorial/normas , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Assistência à Saúde/métodos , Assistência à Saúde/normas , Humanos , Paquistão , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Consulta Remota , Medição de Risco
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