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1.
Medicine (Baltimore) ; 100(16): e25496, 2021 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-33879682

RESUMO

ABSTRACT: Correct follow-up is necessary to avoid under- or overtreatment in the care of patients with treated carcinomas of head and neck. Ultrasound is a cost-effective, harmless, easy, and feasible method. It can be applied in the outpatient clinic in follow-up but the United Kingdom National Multidisciplinary guidelines are recommended computed tomography or magnetic resonance imaging for the detection of metastasis for head and neck carcinomas in the follow-up period. The purpose of the study was to state that neck ultrasound would be the method of choice on follow-up care of Chinese patients who received primary treatment for carcinoma of head and neck.Patients who received primary treatment for carcinoma of the head and neck were examined for 5-years in follow-up through physical, clinical, and neck ultrasound (n = 198). If patients had no evidence of disease after 60 months of definitive therapy considered as a cure. If patients had no evidence of disease after 36 months of salvage therapy considered as a cure of recurrence.Irrespective of definitive treatment used, the study was monitored through neck ultrasound during 5 years of a follow-up visit and was reported cure in 126 (64%) patients and recurrence in 72 (36%; distant metastasis: 33 [17%], local recurrence: 24 [12%], and regional recurrence: 15 [7%]) patients. Primary tumor stage IV, III, II, and I had 63% (15/24), 51% (21/41), 32% (18/56), and 23% (18/77) recurrence, respectively. The time to detect regional recurrence was shorter than that for local recurrence (P < .0001, q = 15.059) and distant recurrence (P < .0001, q = 7.958). Local recurrence and stage I primary tumor had the highest percentage cure for recurrence.Neck ultrasound in the follow-up period is reported to be effective for the detection of recurrence of patients who received primary treatment for carcinoma of head and neck especially regional recurrence and primary tumor stage I.Level of Evidence: III.


Assuntos
Assistência ao Convalescente/métodos , Neoplasias de Cabeça e Pescoço/terapia , Pescoço/diagnóstico por imagem , Recidiva Local de Neoplasia/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/terapia , Adulto , Idoso , Quimiorradioterapia Adjuvante/métodos , Estudos Transversais , Estudos de Viabilidade , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/diagnóstico , Neoplasias de Cabeça e Pescoço/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Pescoço/cirurgia , Recidiva Local de Neoplasia/epidemiologia , Recidiva Local de Neoplasia/prevenção & controle , Estadiamento de Neoplasias , Estudos Retrospectivos , Terapia de Salvação/métodos , Carcinoma de Células Escamosas de Cabeça e Pescoço/diagnóstico , Carcinoma de Células Escamosas de Cabeça e Pescoço/epidemiologia , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia , Adulto Jovem
2.
BMJ Open Respir Res ; 8(1)2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33827856

RESUMO

BACKGROUND: The symptoms, radiography, biochemistry and healthcare utilisation of patients with COVID-19 following discharge from hospital have not been well described. METHODS: Retrospective analysis of 401 adult patients attending a clinic following an index hospital admission or emergency department attendance with COVID-19. Regression models were used to assess the association between characteristics and persistent abnormal chest radiographs or breathlessness. RESULTS: 75.1% of patients were symptomatic at a median of 53 days post discharge and 72 days after symptom onset and chest radiographs were abnormal in 47.4%. Symptoms and radiographic abnormalities were similar in PCR-positive and PCR-negative patients. Severity of COVID-19 was significantly associated with persistent radiographic abnormalities and breathlessness. 18.5% of patients had unscheduled healthcare visits in the 30 days post discharge. CONCLUSIONS: Patients with COVID-19 experience persistent symptoms and abnormal blood biomarkers with a gradual resolution of radiological abnormalities over time. These findings can inform patients and clinicians about expected recovery times and plan services for follow-up of patients with COVID-19.


Assuntos
Assistência ao Convalescente , Biomarcadores/análise , Alta do Paciente/normas , Radiografia Torácica , Avaliação de Sintomas , Assistência ao Convalescente/métodos , Assistência ao Convalescente/organização & administração , /diagnóstico por imagem , /fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Radiografia Torácica/métodos , Radiografia Torácica/estatística & dados numéricos , Recuperação de Função Fisiológica , Estudos Retrospectivos , Índice de Gravidade de Doença , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos , Fatores de Tempo , Reino Unido/epidemiologia
3.
Medicine (Baltimore) ; 100(10): e24072, 2021 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-33725818

RESUMO

BACKGROUND: Blood pressure lowering treatments can help prevent cardiovascular disease. However, little is known about the possibility of home visiting programs for hypertension. This study aims to evaluate the effectiveness of home visiting programs on hypertensive patients. METHODS: We systematically reviewed the medical literature and performed a meta-analysis. Five electronic databases were systematically searched from their inception to September 2019. Two reviewers independently assessed the risk of bias of the studies included in the review using tools developed by the Cochrane Collaboration. The meta-analysis was performed using Review Manager software (version 5.3). RESULTS: Thirteen RCTs with 2674 participants were identified. The home visiting program demonstrated a greater reduction in systolic blood pressure (MD = -5.63, 95% confidence interval (CI): -8.32 to -2.94), diastolic blood pressure (MD = -4.14, 95% CI: -6.72 to -1.56) and waist circumference (MD = -2.61, 95% CI: -3.5, -1.72) during a 6 month intervention. However, there were no significant differences between the groups in terms of body mass index, weight, or blood lipids. CONCLUSION: Home visiting programs were associated with improved BP control and reduced blood pressure, which indicate that it might be an effective method for management of hypertension.


Assuntos
Assistência ao Convalescente/métodos , Visita Domiciliar , Hipertensão/terapia , Cuidados de Enfermagem/métodos , Determinação da Pressão Arterial/estatística & dados numéricos , Humanos , Hipertensão/diagnóstico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
4.
Lung ; 199(2): 113-119, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33569660

RESUMO

The enduring impact of COVID-19 on patients has been examined in recent studies, leading to the description of Long-COVID. We report the lasting symptom burden of COVID-19 patients from the first wave of the pandemic. All patients with COVID-19 pneumonia discharged from a large teaching hospital trust were offered follow-up. We assessed symptom burden at follow-up using a standardised data collection technique during virtual outpatient clinic appointments. Eighty-six percent of patients reported at least one residual symptom at follow-up. No patients had persistent radiographic abnormalities. The presence of symptoms at follow-up was not associated with the severity of the acute COVID-19 illness. Females were significantly more likely to report residual symptoms including anxiety (p = 0.001), fatigue (p = 0.004), and myalgia (p = 0.022). The presence of long-lasting symptoms is common in COVID-19 patients. We suggest that the phenomenon of Long-COVID may not be directly attributable to the effect of SARS-CoV-2, and believe the biopsychosocial effects of COVID-19 may play a greater role in its aetiology.


Assuntos
Assistência ao Convalescente , Ansiedade , Efeitos Psicossociais da Doença , Fadiga , Assistência ao Convalescente/métodos , Assistência ao Convalescente/estatística & dados numéricos , Ansiedade/diagnóstico , Ansiedade/etiologia , /epidemiologia , /psicologia , Fadiga/diagnóstico , Fadiga/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mialgia/diagnóstico , Mialgia/etiologia , Alta do Paciente , /patogenicidade , Fatores Sexuais , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos , Telemedicina/métodos , Reino Unido/epidemiologia
5.
Curr Opin Pulm Med ; 27(3): 199-204, 2021 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-33606410

RESUMO

PURPOSE OF REVIEW: In under a year, coronavirus disease 2019 (COVID-19) has taken the lives of hundreds of thousands of Americans, leaving millions of survivors in its wake. The enormous number of people who survived acute illness but continue to have symptoms has highlighted the need for standardized evaluation of the post-COVID-19 patient. This review, based on the current literature and our experience, aims to guide the care of patients who have survived COVID-19. RECENT FINDINGS: The literature on this topic is rapidly expanding and covers both pulmonary and nonpulmonary complications of COVID-19. Pulmonary complications include dyspnea with normoxia, organizing pneumonia and pulmonary fibrosis. Nonpulmonary complications include neurologic, cardiac, and thromboembolic disease. Special consideration should be taken for COVID-19 survivors of intensive care. SUMMARY: The current review outlines the major clinical findings in post-COVID-19 patients and provides a guidelines to the evaluation and management of prolonged symptoms.


Assuntos
Assistência ao Convalescente/métodos , Estado Terminal/reabilitação , /patogenicidade , /complicações , /terapia , Cuidados Críticos/métodos , Humanos , Pesquisa de Reabilitação , Sobreviventes
6.
Plast Surg Nurs ; 41(1): 36-39, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33626561

RESUMO

On March 11, 2020, the World Health Organization declared COVID-19 to be a pandemic, challenging health care systems all over the world. National health care systems have reorganized to cope with the disease. Surgical services departments around the world have been affected and elective surgical procedures have been postponed to conserve medical resources. When a patient with COVID-19 requires an urgent microsurgical free flap due to trauma or a tumor, personnel from the health care facility must have a protocol in place to follow for the patient's care and follow-up. In this article, we present our protocol for patients with COVID-19 requiring reconstructive microsurgery.


Assuntos
/prevenção & controle , Retalhos de Tecido Biológico/transplante , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Microcirurgia/métodos , Assistência Perioperatória/métodos , Procedimentos Cirúrgicos Reconstrutivos/métodos , Assistência ao Convalescente/métodos , Assistência ao Convalescente/normas , /transmissão , Protocolos Clínicos , Hospitais Universitários , Humanos , Controle de Infecções/normas , Microcirurgia/normas , Assistência Perioperatória/normas , Procedimentos Cirúrgicos Reconstrutivos/normas , Espanha
7.
Dig Surg ; 38(2): 158-165, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33640885

RESUMO

BACKGROUND: This survey aimed to register changes determined by the COVID-19 pandemic on pancreatic surgery in a specific geographic area (Germany, Austria, and Switzerland) to evaluate the impact of the pandemic and obtain interesting cues for the future. METHODS: An online survey was designed using Google Forms focusing on the local impact of the pandemic on pancreatic surgery. The survey was conducted at 2 different time points, during and after the lockdown. RESULTS: Twenty-five respondents (25/56) completed the survey. Many aspects of oncological care have been affected with restrictions and delays: staging, tumor board, treatment selection, postoperative course, adjuvant treatments, outpatient care, and follow-up. Overall, 60% of respondents have prioritized pancreatic cancer patients according to stage, age, and comorbidities, and 40% opted not to operate high-risk patients. However, for 96% of participants, the standards of care were guaranteed. DISCUSSION/CONCLUSIONS: The first wave of the COVID-19 pandemic had an important impact on pancreatic cancer surgery in central Europe. Guidelines for prompt interventions and prevention of the spread of viral infections in the surgical environment are needed to avoid a deterioration of care in cancer patients in the event of a second wave or a new pandemic. High-volume centers for pancreatic surgery should be preferred and their activity maintained. Virtual conferences have proven to be efficient during this pandemic and should be implemented in the near future.


Assuntos
/prevenção & controle , Acesso aos Serviços de Saúde/tendências , Pancreatectomia/tendências , Neoplasias Pancreáticas/cirurgia , Padrões de Prática Médica/tendências , Assistência ao Convalescente/métodos , Assistência ao Convalescente/normas , Assistência ao Convalescente/tendências , Atitude do Pessoal de Saúde , Europa (Continente)/epidemiologia , Pesquisas sobre Serviços de Saúde , Acesso aos Serviços de Saúde/normas , Humanos , Controle de Infecções/métodos , Controle de Infecções/tendências , Estadiamento de Neoplasias , Pancreatectomia/normas , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/patologia , Pandemias , Aceitação pelo Paciente de Cuidados de Saúde , Assistência Perioperatória/métodos , Assistência Perioperatória/normas , Assistência Perioperatória/tendências , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/normas , Tempo para o Tratamento/normas , Tempo para o Tratamento/tendências
8.
Medicine (Baltimore) ; 100(6): e24700, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578606

RESUMO

RATIONALE: Double primary lung cancer (DPLC) is a relatively rare type of lung cancers. According to whether the diagnosis interval between lesions is more than 6 months, it can be divided into synchronous DPLC (sDPLC) and metachronous DPLC (mDPLC). Here, we describe a case of sDPLC in which one of the components is a rare colloid adenocarcinoma (CA). PATIENT CONCERNS: A 69-year-old male was admitted to the hospital due to chest distress and shortness of breath for 1 year, getting worse in the last 15 days. DIAGNOSIS: Both HE staining and IHC supported the diagnosis of CA in the right lower lobe and moderately differentiated squamous cell carcinoma in the right upper lobe. INTERVENTIONS: The patient was treated with 3 cycles of adjuvant chemotherapy with pemetrexed and lobaplatin after the right upper lobectomy, wedge resection of the right lower lobe and lymph node dissection under video-assisted thoracoscope. OUTCOMES: Our plan was to follow him up with general physical examination, chest-abdomen CT and serum tumor markers every 6 months for 2 years. The patient was still alive until the last follow-up in November 2020. LESSONS: CA of the lung is a rare primary lung adenocarcinoma. The diagnosis should be based on the patient's clinical characteristics, imaging examination and pathological characteristics, and also need to be differentiated from other mucinous adenocarcinomas. Interestingly, our patient developed not only a CA in the right lower lobe, but also a moderately differentiated squamous cell carcinoma in the right upper lobe.


Assuntos
Adenocarcinoma Mucinoso/patologia , Adenocarcinoma/patologia , Carcinoma de Células Escamosas/patologia , Neoplasias Pulmonares/patologia , Neoplasias Primárias Múltiplas/patologia , Adenocarcinoma/terapia , Adenocarcinoma Mucinoso/metabolismo , Adenocarcinoma Mucinoso/terapia , Assistência ao Convalescente/métodos , Idoso , Biomarcadores Tumorais/sangue , Carcinoma de Células Escamosas/metabolismo , Carcinoma de Células Escamosas/terapia , Quimioterapia Adjuvante/métodos , Diagnóstico Diferencial , Dispneia/diagnóstico , Dispneia/etiologia , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/metabolismo , Excisão de Linfonodo/métodos , Masculino , Estadiamento de Neoplasias/métodos , Neoplasias Primárias Múltiplas/terapia , Cirurgia Torácica Vídeoassistida/métodos , Tomografia Computadorizada por Raios X/métodos , Resultado do Tratamento
10.
Adv Ther ; 38(2): 1011-1023, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33459975

RESUMO

The rapid spread of novel coronavirus (COVID-19) has posed complex challenges to global public health. During this pandemic period, access to essential services including post-abortion care (PAC) has been disrupted. Along with the clinical management of the disease in women, protection of the healthcare workers and medical staff from nosocomial infection is important to ensure infection control. Thus, in order to implement the proper contraceptive measures and to reduce the rate of repeated abortion, the family planning group of minimally invasive gynecological branch of the Liaoning Medical Association organized a committee of experts to formulate guidance and suggestions to ensure the timely treatment and surgery of women opting for abortion, the implementation of PAC, implementation of safe contraceptive measures after surgery, and the protection of healthcare professionals and medical staff from infection. We believe these guidelines might be helpful for obstetrics and gynecology departments in China and globally, as well for women who wish to undergo abortion during these unprecedented times.


Assuntos
Aborto Induzido , Assistência ao Convalescente/métodos , Anticoncepção/métodos , Serviços de Planejamento Familiar/métodos , Controle de Infecções , Guias de Prática Clínica como Assunto , Telemedicina , Abortivos/uso terapêutico , China , Consenso , Anticoncepcionais , Feminino , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Pandemias , Equipamento de Proteção Individual , Gravidez , Autogestão , Triagem
11.
Isr Med Assoc J ; 23(1): 12-16, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33443336

RESUMO

BACKGROUND: Dietary modifications and patient-tailored medical management are significant in controlling renal stone disease. Nevertheless, the literature regarding effectiveness is sparse. OBJECTIVES: To explore the impact of dietary modifications and medical management on 24-hour urinary metabolic profiles (UMP) and renal stone status in recurrent kidney stone formers. METHODS: We reviewed our prospective registry database of patients treated for nephrolithiasis. Data included age, sex, 24-hour UMP, and stone burden before treatment. Under individual treatment, patients were followed at 6-8 month intervals with repeat 24-hour UMP and radiographic images. Nephrolithiasis-related events (e.g., surgery, renal colic) were also recorded. We included patients with established long-term follow-up prior to the initiation of designated treatment, comparing individual nephrolithiasis status before and after treatment initiation. RESULTS: Inclusion criteria were met by 44 patients. Median age at treatment start was 60.5 (50.2-70.2) years. Male:Female ratio was 3.9:1. Median follow-up was 10 (6-25) years and 5 (3-6) years before and after initiation of medical and dietary treatment, respectively. Metabolic abnormalities detected included: hypocitraturia (95.5%), low urine volume (56.8%), hypercalciuria (45.5%), hyperoxaluria (40.9%), and hyperuricosuria (13.6%). Repeat 24-hour UMP under appropriate diet and medical treatment revealed a progressive increase in citrate levels compared to baseline and significantly decreased calcium levels (P = 0.001 and 0.03, respectively). A significant decrease was observed in stone burden (P = 0.001) and overall nephrolithiasis-related events. CONCLUSIONS: Dietary modifications and medical management significantly aid in correcting urinary metabolic abnormalities. Consequently, reduced nehprolithiasis-related events and better stone burden control is expected.


Assuntos
Dietoterapia/métodos , Cálculos Renais , Nefrolitíase , Assistência ao Convalescente/métodos , Assistência ao Convalescente/estatística & dados numéricos , Cálcio/urina , Ácido Cítrico/urina , Feminino , Humanos , Israel/epidemiologia , Cálculos Renais/complicações , Cálculos Renais/epidemiologia , Cálculos Renais/fisiopatologia , Masculino , Conduta do Tratamento Medicamentoso/estatística & dados numéricos , Metaboloma/efeitos dos fármacos , Metaboloma/fisiologia , Pessoa de Meia-Idade , Monitorização Fisiológica/métodos , Nefrolitíase/diagnóstico , Nefrolitíase/dietoterapia , Nefrolitíase/tratamento farmacológico , Nefrolitíase/metabolismo , Avaliação de Processos e Resultados em Cuidados de Saúde , Cólica Renal/epidemiologia , Cólica Renal/etiologia , Prevenção Secundária/métodos , Prevenção Secundária/estatística & dados numéricos , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Ácido Úrico/urina
12.
J Urol ; 205(1): 206-212, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32716692

RESUMO

PURPOSE: We sought to determine whether prolonged interventional test phase increases cumulative success rate and compared success rates between early responders (ie within 1 week) and those in need for reprogramming (due to lack of efficacy) of sacral neuromodulation after 1-year followup. MATERIALS AND METHODS: In a single tertiary center prospective study (August 2015 to November 2018) 90 patients refractory to first line treatment were eligible for sacral neuromodulation, including 48 overactive bladder wet (53%), 8 overactive bladder dry (9%) and 34 nonobstructive urinary retention (38%). Patients were evaluated at weekly intervals during test phase and those not successful were reprogrammed. This could be repeated after the second week. Primary outcome was success rate after 3-week test phase and after 1-year followup. Statistical analysis was done by nonparametric tests for numeric (Mann-Whitney U) and categorical (chi2) data. RESULTS: After 3 weeks of test period 56 patients (62%) were considered successful. Prolonged interventional testing increased cumulative success. A 1-year followup showed no significant difference in success rate between early responders and those in need for reprogramming (chi2, p=0.562). There was no difference in age (Mann-Whitney U, p=0.222), sex (chi2, p=0.952) or indication (chi2, p= 0.975). CONCLUSIONS: A 3-week test phase with close followup increases cumulative success rate. During this supervised 3-week test phase 42% of the initial nonresponders after the first week became successful candidates after reprogramming. Patients who required this additional programming did equally as well as those without need for reprogramming. A supervised 3-week test phase is therefore strongly recommended.


Assuntos
Assistência ao Convalescente/métodos , Terapia por Estimulação Elétrica/métodos , Plexo Lombossacral/fisiopatologia , Bexiga Urinária Hiperativa/terapia , Retenção Urinária/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia por Estimulação Elétrica/instrumentação , Eletrodos Implantados , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Resultado do Tratamento , Bexiga Urinária/inervação , Bexiga Urinária/fisiopatologia , Bexiga Urinária Hiperativa/fisiopatologia , Retenção Urinária/fisiopatologia
13.
Support Care Cancer ; 29(1): 85-96, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32803729

RESUMO

PURPOSE: To care for the growing population of cancer survivors, health services worldwide must reconsider how to deliver care to people living with and beyond a cancer diagnosis. Shared care, defined as cancer care that is shared between specialist and primary care providers, is one model that has been investigated; however, practical guidance to support implementation is lacking. This systematic review aimed to explore facilitators and barriers to implementing shared cancer care and to develop practice and policy recommendations to support implementation. METHODS: A systematic literature search was conducted in June 2019 across MEDLINE, Embase, Emcare, and PsycINFO databases. Quantitative and qualitative data relevant to the review question were extracted and synthesized following a mixed methods approach. RESULTS: Thirteen papers were included in the review, 10 qualitative and three quantitative. Included articles were from Australia (n = 8), the USA (n = 3), and one each from the UK and the Netherlands. Sixteen themes were developed under four categories of patient, healthcare professional, process, and policy factors. Key themes included the perceived need for primary care provider training, having clearly defined roles for each healthcare provider, providing general practitioners with diagnostic and treatment summaries, as well as protocols or guidelines for follow-up care, ensuring rapid and accurate communication between providers, utilizing electronic medical records and survivorship care plans as communication tools, and developing consistent policy to reduce fragmentation across services. CONCLUSION: Recommendations for practice and policy were generated based on review findings that may support broader implementation of shared cancer care.


Assuntos
Assistência ao Convalescente/métodos , Sobreviventes de Câncer/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Relações Interprofissionais , Atenção Primária à Saúde/métodos , Austrália , Feminino , Humanos , Neoplasias/terapia , Países Baixos , Sobrevivência
14.
BMC Med ; 18(1): 391, 2020 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-33323098

RESUMO

BACKGROUND: Mobile health innovations are well adapted for ambulatory coronavirus disease 2019 (COVID-19) patients who risk clinical deterioration at home during the second week of illness. METHODS: A short message service (SMS) communication program was implemented by French physicians to monitor COVID-19 patients after discharge from outpatient or emergency care. The aim of the SMS tracking is to advise patients about their need for medical reassessment if reporting worsening of COVID-19 symptoms. A follow-up via SMS to all confirmed positive patients in the Nîmes area (France) was established. Every morning, patients received four follow-up questions. Daily responses were converted to green, orange or red trees, analysed in real time by physicians. "Red" patients were called immediately to check their condition and organise transfer to hospital if needed. "Orange" patients were called within two hours to verify whether the specific instructions following the SMS had been followed. RESULTS: From March 21 to June 30, 2020, 1007 patients agreed to sign up to the SMS tracking, 62% were women and the mean age was 41.5 years (standard deviation (SD) 16.0). During follow-up, 649 (64%) became "orange" and 69 (7%) "red". Ten patients were directly admitted to the Infectious Diseases Department during their follow-up due to clinical worsening, all but one as a result of SMS alerts and subsequent telephone assessment by physicians. CONCLUSION: SMS tracking platforms could be useful as an early warning system to refer patients with worsening clinical status to hospital-based care or additional clinician advice.


Assuntos
Assistência ao Convalescente/métodos , Telemedicina/métodos , Envio de Mensagens de Texto , Adulto , Comunicação , Feminino , França , Humanos , Masculino
15.
J Laryngol Otol ; 134(12): 1081-1084, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33327972

RESUMO

OBJECTIVE: The purpose of this article was to determine the impact of employing a telephone clinic for follow-up of patients with stable lateral skull-base tumours. METHOD: An analysis of 1515 patients in the national lateral skull-base service was performed, and 148 patients enrolled in the telephone clinic to date were identified. The length of time that patients waited for results of their follow-up scans and the travel distance saved by patients not having to attend the hospital for their results was determined. RESULTS: The mean time from scan to receiving results was 30.5 ± 32 days, 14 days sooner than in the face-to-face group (p = 0.0016). The average round-trip distance travelled by patients to the hospital for results of their scans was 256 ± 131 km. CONCLUSION: The telephone clinic led to a significant reduction in time until patients received their scan results and helped reduce travel distance and clinic numbers in traditional face-to-face clinics.


Assuntos
Assistência ao Convalescente/métodos , Neoplasias da Base do Crânio/diagnóstico , Telemedicina/métodos , Telefone/instrumentação , Assistência ao Convalescente/estatística & dados numéricos , Humanos , Administração dos Cuidados ao Paciente/métodos , Estudos Prospectivos , Neoplasias da Base do Crânio/epidemiologia , Neoplasias da Base do Crânio/patologia , Neoplasias da Base do Crânio/terapia , Telemedicina/estatística & dados numéricos , Fatores de Tempo , Viagem/estatística & dados numéricos
16.
Ned Tijdschr Geneeskd ; 1642020 12 10.
Artigo em Holandês | MEDLINE | ID: mdl-33332052

RESUMO

OBJECTIVE: To gain insight into 1) the symptoms and the disease process of healthcare professionals (HCPs) who tested positive for COVID-19 and were not hospitalized because of mild symptoms, 2) the impact on their psychological well-being and 3) the experiences with (after) care and infection prevention measures. DESIGN: Explorative mixed-methods study. METHOD: The municipal public health services of Groningen and Fryslân invited all HCPs aged above 18 years who tested positive for COVID-19 between March 18th and April 3rd 2020 to fill out an online questionnaire (n = 109), on average one month after diagnosis. 18 HCPs participated in telephone interviews. RESULTS: Almost all HCPs mentioned fatigue as a long-term symptom, less frequently mentioned were, among other things, feeling physically weak and having a cold. Nearly half of them did not have a fever, two-thirds experienced stress. HCPs with comorbidity had more symptoms. The interviews showed that stress in particular occurred in families with children and because of uncertainty about the duration of infectiousness, with lack of good (after)care. Respondents experienced many negative reactions of people in their environment that felt stigmatizing. The isolation at home was considered bearable. CONCLUSION: A COVID-19 infection has a significant impact on physical and mental health, even in HCPs with mild symptoms. Persistent fatigue in particular hinders patients' functioning. The absence of fever in almost half of the respondents is remarkable, as well as the negative impact on psychological well-being. HCPs are also dissatisfied with after-care. Infection prevention measures were relatively well-adhered too.


Assuntos
Assistência ao Convalescente , Fadiga , Pessoal de Saúde , Saúde Mental , Estresse Psicológico , Adulto , Assistência ao Convalescente/métodos , Assistência ao Convalescente/psicologia , Assistência ao Convalescente/normas , /fisiopatologia , /reabilitação , Autoavaliação Diagnóstica , Fadiga/diagnóstico , Fadiga/etiologia , Feminino , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Humanos , Entrevistas como Assunto , Masculino , Determinação de Necessidades de Cuidados de Saúde , Países Baixos/epidemiologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/etiologia
17.
Eur Rev Med Pharmacol Sci ; 24(21): 11402-11408, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33215462

RESUMO

OBJECTIVE: The study aimed to explore the best follow-up management strategy for patients undergoing peritoneal dialysis (PD) during the novel coronavirus pneumonia (NCP) epidemic. PATIENTS AND METHODS: Patients undergoing PD who were followed up during the NCP epidemic by our hospital were enrolled in this study. Because of the need to control the epidemic, a follow-up system was established during the epidemic period, with WeChat, QQ, and the telephone as the main methods of communication. Outpatient and emergency follow-ups were carried out to ensure the safety of dialysis and the prevention and control of the epidemic. The follow-up strategy included response measures related to the epidemic situation, prevention of peritonitis related to PD, water and salt control, exercise guidance, and psychological care. According to the patient's condition, the appointment system was implemented, with one consulting room and one process for each patient. The emergency patients were isolated in accordance with the epidemic situation. RESULTS: Since January 2020, among the 580 patients undergoing PD who were followed up in our department and their families, none had NCP infection. During the epidemic period, the standard hemoglobin level and the inpatient rate decreased. Complications related to PD, such as peritonitis, cardiovascular complications caused by volume overload, and pulmonary infection, did not significantly increase, and the withdrawal rate and mortality rate decreased compared with those in the same period last year. CONCLUSIONS: The patient follow-up strategy during the epidemic period had a significant positive effect on preventing and controlling the epidemic. Furthermore, during the epidemic period, encouraging patients and caregivers to pay attention to protection at home, avoid going out, strengthen self-management, and other measures were beneficial to the control of kidney disease itself, which is worth promoting. The close relationship between doctors and patients during the epidemic had a positive effect on the occurrence of complications related to patients undergoing PD.


Assuntos
Assistência ao Convalescente/métodos , Infecções por Coronavirus/prevenção & controle , Hemodiálise no Domicílio/normas , Falência Renal Crônica/terapia , Pandemias/prevenção & controle , Diálise Peritoneal/normas , Pneumonia Viral/prevenção & controle , Assistência ao Convalescente/normas , Betacoronavirus/patogenicidade , Cuidadores/psicologia , Controle de Doenças Transmissíveis/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Seguimentos , Hemodiálise no Domicílio/efeitos adversos , Hemodiálise no Domicílio/psicologia , Humanos , Educação de Pacientes como Assunto , Diálise Peritoneal/efeitos adversos , Diálise Peritoneal/psicologia , Peritonite/epidemiologia , Peritonite/etiologia , Relações Médico-Paciente , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Guias de Prática Clínica como Assunto , Encaminhamento e Consulta/normas , Autogestão/psicologia , Telemedicina/normas , Resultado do Tratamento
19.
Inflamm Bowel Dis ; 26(11): e134-e136, 2020 10 23.
Artigo em Inglês | MEDLINE | ID: mdl-33029612
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