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1.
Artigo em Inglês | MEDLINE | ID: mdl-32503333

RESUMO

Virus outbreaks are threats to humanity, and coronaviruses are the latest of many epidemics in the last few decades in the world. SARS-CoV (Severe Acute Respiratory Syndrome Associated Coronavirus) is a member of the coronavirus family, so its study is useful for relevant virus data research. In this work, we conduct a proposed approach that is non-medical/clinical, generate graphs from five features of the SARS outbreak data in five countries and regions, and offer insights from a visual analysis perspective. The results show that prevention measures such as quarantine are the most common control policies used, and areas with strict measures did have fewer peak period days; for instance, Hong Kong handled the outbreak better than other areas. Data conflict issues found with this approach are discussed as well. Visual analysis is also proved to be a useful technique to present the SARS outbreak data at this stage; furthermore, we are proceeding to apply a similar methodology with more features to future COVID-19 research from a visual analysis perfective.


Assuntos
Análise de Dados , Surtos de Doenças/prevenção & controle , Surtos de Doenças/estatística & dados numéricos , Internacionalidade , Quarentena/estatística & dados numéricos , Síndrome Respiratória Aguda Grave/epidemiologia , Síndrome Respiratória Aguda Grave/prevenção & controle , Conferências de Consenso como Assunto , Hong Kong/epidemiologia , Humanos , Controle de Infecções , Síndrome Respiratória Aguda Grave/transmissão , Fatores de Tempo , Organização Mundial da Saúde
2.
Neurología (Barc., Ed. impr.) ; 35(4): 258-263, mayo 2020.
Artigo em Espanhol | IBECS | ID: ibc-187527

RESUMO

INTRODUCCIÓN: La pandemia por COVID-19 ha obligado a una reorganización de los sistemas sanitarios y una saturación excepcional de sus recursos. En este contexto es vital asegurar la atención al ictus agudo y optimizar los procesos asistenciales del código ictus para reducir el riesgo de contagios y racionalizar el uso de recursos hospitalarios. Para ello desde el Grupo multidisciplinar Ictus Madrid proponemos una serie de recomendaciones. MÉTODOS: Revisión bibliográfica no sistemática de las publicaciones disponibles con los términos "stroke" y "covid-19" o "coronavirus" o "SARS-COV-2", así como otras conocidas por los autores. En base a ésta se redacta un documento de recomendaciones que es sometido a consenso por el Grupo multidisciplinar Ictus Madrid y su Comité de Neurología. RESULTADOS: Las recomendaciones se estructuran en cinco líneas fundamentales: (1) Coordinar la actuación para garantizar el acceso la asistencia hospitalaria de los pacientes con ictus, (2) Reconocer a los pacientes con ictus potencialmente infectados por COVID-19, (3) Organización adecuada para garantizar la protección de los profesionales sanitarios frente al riesgo de contagio por COVID-19, (4) la realización de Neuroimagen y otros procedimientos que conlleven contactos de riesgo de infección COVID-19 hay que procurar reducirlos y asegurar la protección, y (5) alta y seguimiento seguros procurando optimizar la ocupación hospitalaria. Resumimos el procedimiento de forma esquemática con el acrónimo CORONA (COordinar, Reconocer, Organizar, Neuroimagen, Alta). CONCLUSIONES: Estas recomendaciones pueden servir de apoyo para la organización del sistema sanitario en la atención al ictus agudo y la optimización de sus recursos, garantizando la protección de sus profesionales


BACKGROUND: The COVID-19 pandemic has forced a reorganization of healthcare systems and an exceptional saturation of their resources. In this context, it is vital to ensure acute stroke care and optimize the care processes of the stroke code to reduce the risk of contagion and rationalize the use of hospital resources. To do this, the Ictus Madrid multidisciplinary group proposes a series of recommendations. METHODS: Non-systematic bibliographic review of the available publications with the terms "stroke" and "covid-19" or "coronavirus" or "SARS-COV-2", as well as other already known for the authors. We provide a document of recommendations as a result of the consensus of the Ictus Madrid multidisciplinary group and its Neurology Committee. RESULTS: Our recommendations are structured on five lines: (1) Coordinate to guarantee the access to hospital care for stroke patients, (2) Recognize potentially COVID-19 infected stroke patients, (3) Organize to ensure the protection of healthcare professionals from COVID-19 infections, (4) Neuroimaging and other procedures potentially associated to risks for COVID-19 infection should be reduced and secured to avoid contagion, and (5) At home as soon as posible and supported follow-up to optimize hospital occupancy. The procedure is shown summarized under the acronym CORONA (Coordinate, Recognize, Organize, Neuroimaging, At home). CONCLUSIONS: These recommendations can support the organization of healthcare services for acute stroke care and the optimization of their resources, guaranteeing the protection of healthcare professionals


Assuntos
Humanos , Infecções por Coronavirus/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/prevenção & controle , Betacoronavirus , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Acidente Vascular Cerebral/terapia , Acesso aos Serviços de Saúde , Pandemias , Conferências de Consenso como Assunto
3.
Neurología (Barc., Ed. impr.) ; 35(4): 252-257, mayo 2020.
Artigo em Espanhol | IBECS | ID: ibc-187531

RESUMO

INTRODUCCIÓN: La pandemia de Covid-19 va a conllevar cambios en la asistencia neurológica, que no se pueden prever fácilmente a largo plazo. MATERIAL Y MÉTODOS: A través de un modelo de informadores clave, se busca el consenso siendo los encuestados, jefes de servicio de Neurología con conocimiento amplio de la situación al haber actuado durante la pandemia, de cómo va a ser la especialidad en un plazo de cinco años. RESULTADOS: Aunque se obtiene un grado de acuerdo bajo entre encuestados, si se describen acuerdos por consenso a nivel mayor (85%) y menor (70%). Los principales acuerdos se refieren al incremento de precauciones, al uso de la telemedicina, al mantenimiento de las consultas telefónicas, a la reducción de asistencia a las consultas evitando que hayan salas de espera con un número alto de personas, al desarrollo de técnicas docentes no presenciales y a la adaptación en el desarrollo de ensayos clínicos en relación a la visita de los monitores. Sin embargo, no se acuerda que haya cambios en la indicación de exploraciones complementarias, ni en la propia exploración neurológica. CONCLUSIÓN: El método de informadores clave ha permitido conocer que cambios se pueden prever tras la pandemia


INTRODUCTION: The COVID-19 pandemic will give rise to long-term changes in neurological care, which are not easily predictable. MATERIAL AND METHODS: A key informant survey was used to enquire about the changes expected in the specialty over the next 5 years. The survey was completed by heads of neurology departments with broad knowledge of the situation, having been active during the pandemic. RESULTS: Despite a low level of consensus between participants, there was strong (85%) and moderate consensus (70%) about certain subjects, mainly the increase in precautions to be taken, the use of telemedicine and teleconsultations, the reduction of care provided in in-person consultations to avoid the presence of large numbers of people in waiting rooms, the development of remote training solutions, and the changes in monitoring visits during clinical trials. There was consensus that there would be no changes to the indication of complementary testing or neurological examination. CONCLUSION: The key informant survey identified the foreseeable changes in neurological care after the pandemic


Assuntos
Humanos , Neurologia/tendências , Administração da Prática Médica/tendências , Administração dos Cuidados ao Paciente/tendências , Infecções por Coronavirus , Pneumonia Viral , Betacoronavirus , Pandemias , Conferências de Consenso como Assunto
4.
Braz Oral Res ; 34(supp1 1): e027, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32294680

RESUMO

Periodontal diseases are considered a worldwide public health problem, owing to their high prevalence in developed and developing countries. Periodontitis may lead to tooth loss, which can impact oral health-related quality of life. Gingivitis and periodontitis have been extensively studied regarding their etiopathogenesis, epidemiology, prevention and treatment outcomes. However, most of these aspects are studied and discussed globally, which may hamper a clear interpretation of the findings and the design of effective plans of action for specific regions or populations. For example, in Latin America, epidemiological data about the distribution of periodontal diseases is still scarce, mainly when it comes to nationwide representative samples. This Consensus aimed to address the following topics related to periodontal diseases in Latin America: a) The impact of the global burden of periodontal diseases on health: a global reality; b) Periodontal diseases in Latin America; c) Strategies for the prevention of periodontal diseases in Latin America; d) Problems associated with diagnosis of periodontal conditions and possible solutions for Latin America; e) Treatment of Periodontitis. This consensus will help to increase awareness about diagnosis, prevention and treatment of periodontal diseases, in the context of Latin American countries.


Assuntos
Conferências de Consenso como Assunto , Doenças Periodontais/terapia , Feminino , Gengivite/diagnóstico , Gengivite/epidemiologia , Gengivite/terapia , Carga Global da Doença , Humanos , América Latina/epidemiologia , Masculino , Saúde Bucal , Doenças Periodontais/diagnóstico , Doenças Periodontais/epidemiologia , Periodontite/diagnóstico , Periodontite/epidemiologia , Periodontite/terapia , Qualidade de Vida
7.
Br J Radiol ; 93(1110): 20200117, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32207989

RESUMO

Among lesions with uncertain malignant potential found at percutaneous breast biopsy, atypical ductal hyperplasia (ADH) carries both the highest risk of underestimation and the closest and most pathologist-dependent differential diagnosis with ductal carcinoma in situ (DCIS), matching the latter's features save for size only. ADH is therefore routinely surgically excised, but single-centre studies with limited sample size found low rates of upgrade to invasive cancer or DCIS. This suggests the possibility of surveillance over surgery in selected subgroups, considering the 2% threshold allowing for follow-up according to the Breast Imaging Reporting and Data System. A recent meta-analysis on 6458 lesions counters this approach, confirming that, surgically excised or managed with surveillance, ADH carries a 29% and 5% upgrade rate, respectively, invariably higher than 2% even in subgroups considering biopsy guidance and technique, needle calibre, apparent complete lesion removal. The high heterogeneity (I2 = 80%) found in this meta-analysis reaffirmed the need to synthesise evidence from systematic reviews to achieve generalisable results, fit for guidelines development. Limited tissue sampling at percutaneous biopsy intrinsically hampers the prediction of ADH-associated malignancy. This prediction could be improved by using contrast-enhanced breast imaging and applying artificial intelligence on both pathology and imaging results, allowing for overtreatment reduction.


Assuntos
Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Carcinoma Intraductal não Infiltrante/cirurgia , Inteligência Artificial , Biópsia/métodos , Biópsia por Agulha Fina/métodos , Mama/cirurgia , Calcinose/patologia , Conferências de Consenso como Assunto , Feminino , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Conduta Expectante
8.
Einstein (Sao Paulo) ; 18: eAE4799, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32215466

RESUMO

The Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplantation: Graft- versus -host disease was approved by Sociedade Brasileira de Transplante de Medula Óssea , with the participation of 26 Brazilian hematopoietic stem cell transplantation centers. It describes the main nutritional protocols in cases of Graft- versus -host disease, the main complication of hematopoietic stem cell transplantation.


Assuntos
Conferências de Consenso como Assunto , Doença Enxerto-Hospedeiro/dietoterapia , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Terapia Nutricional/normas , Necessidades Nutricionais , Brasil , Congressos como Assunto , Gastroenteropatias/dietoterapia , Gastroenteropatias/etiologia , Gastroenteropatias/fisiopatologia , Doença Enxerto-Hospedeiro/fisiopatologia , Humanos , Terapia Nutricional/métodos , Índice de Gravidade de Doença
9.
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 31(1): 24-36, ene.-feb. 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-ET2-5223

RESUMO

La monitorización continua de la oxigenación cerebral y su aplicación al manejo del paciente neurológico grave es uno de los grandes retos actuales de la medicina crítica. Aunque han sido descritas diversas técnicas para la monitorización de la oxigenación cerebral, la monitorización tisular cerebral de oxígeno proporciona una relevante información sobre los niveles de oxígeno a nivel del tejido cerebral. Su desarrollo se ha asociado a la necesidad de responder no solamente aspectos técnicos sobre la misma, sino también al significado de la alteración de los valores de la oxigenación cerebral en el paciente neurocrítico. El documento de consenso da respuesta a diversas cuestiones relativas a la monitorización de la oxigenación cerebral mediante sensor de presión tisular cerebral de oxígeno. Para ello se elaboró un panel de preguntas y se realizó una revisión de la literatura médica, y evaluando la calidad de la evidencia y el nivel de recomendación mediante la metodología GRADE


Continuous monitoring of cerebral oxygenation and its application to the management of the severe neurological patient is a challenge for the management of patients with acute critical brain damage. Although several techniques have been described for monitoring brain, brain tissue oxygen monitoring provides relevant information about oxygen levels of brain tissue. However, the development of this technique has been associated with the need to answer not only some technical aspects of it as well as the meaning of the changes of the cerebral oxygenation in the neurocritical patient. The consensus document responds to various questions related to the monitoring of cerebral oxygenation by means of a cerebral oxygen tissue pressure sensor. For this purpose, a list of questions was prepared and a reviewed of the medical literature was made. The quality of the evidence and the degree of recommendation was evaluated using the GRADE methodology


Assuntos
Humanos , Conferências de Consenso como Assunto , Pressão Intracraniana/fisiologia , Lesões Encefálicas/metabolismo , Cuidados Críticos , Oximetria/métodos , Monitorização Fisiológica/normas , Consumo de Oxigênio/fisiologia , Lesões Encefálicas/complicações , Circulação Cerebrovascular , Cérebro/metabolismo
11.
Ann Allergy Asthma Immunol ; 124(5): 479-486, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32007568

RESUMO

BACKGROUND: Peanut allergy is a potentially severe and lifelong allergy, with few effective treatments or preventive measures. OBJECTIVE: To convene an expert panel of allergists, pediatricians, and advocates to discuss and highlight unmet needs in the prevention and management of peanut allergies. METHODS: Literature searches of PubMed were performed. The panel evaluated published data on the prevention of peanut allergy, treatment of existing peanut allergy, and management of reactions after unintentional peanut exposures. RESULTS: The following key unmet needs in the prevention and management of peanut allergy were identified: (1) enhancing and optimizing implementation of early peanut introduction as a means of preventing the development of peanut allergy, (2) developing knowledge translation strategies regarding the safety and efficacy data for current and emerging immunotherapies for peanut-allergic children to support their use in clinical practice, and (3) promoting understanding of true exposure risk in allergic individuals and ensuring access to epinephrine for unintentional exposures that provoke severe reactions. Practitioners should help educate caregivers about the actual risks associated with peanut allergy and its prevention and management so that treatment decisions can be evidence based rather than fear based. Support tools are needed to help address caregiver goals, expectations, and psychological barriers, as well as identify facilitators for prevention and treatment strategies. CONCLUSION: There are significant unmet needs in our understanding of peanut allergy; addressing these needs will help to enhance understanding of how to most effectively prevent and treat peanut allergy, as well as educate the food-allergic and nonallergic community regarding current evidence-based practices.


Assuntos
Anafilaxia/epidemiologia , Anafilaxia/prevenção & controle , Prática Clínica Baseada em Evidências , Acesso aos Serviços de Saúde/estatística & dados numéricos , Hipersensibilidade a Amendoim/epidemiologia , Fatores Etários , Cuidadores , Criança , Conferências de Consenso como Assunto , Dessensibilização Imunológica , Prova Pericial , Humanos , Disseminação de Informação , Educação de Pacientes como Assunto , Risco , Estados Unidos/epidemiologia
13.
Gastroenterol. hepatol. (Ed. impr.) ; 43(2): 97-105, feb. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-188305

RESUMO

Aunque un elevado porcentaje de pacientes con colitis ulcerosa debería recibir tratamiento tópico por vía rectal, los estudios de práctica clínica han demostrado que este está infrautilizado. El propósito de este artículo es el de responder a 10 preguntas concretas sobre qué fármacos están disponibles para uso tópico, su forma de presentación, formulación y métodos de aplicación, así como cuál de ellos es más eficaz e idóneo en los distintos escenarios clínicos de la colitis ulcerosa. Asimismo, se evalúa la posibilidad de combinar diferentes formulaciones y vías de administración, y la utilidad en la fase de remisión de la enfermedad. Por último, se hacen una serie de recomendaciones para una mejor información de los pacientes acerca de una correcta aplicación y administración


Although most patients with ulcerative colitis should be given topical treatment, different studies have shown that they are underused in clinical practice. The purpose of this article is to answer 10 specific questions about which drugs are available for topical use in the treatment of ulcerative colitis, and their characteristics in terms of formulation, dosage, presentation, application and proximal distribution of rectal-administered drugs. The efficacy of available topical drugs and the benefits of combining different formulations and routes of administration, and their usefulness during disease remission are evaluated. Finally, a series of recommendations addressed to patients are given on the correct application of topical treatment


Assuntos
Humanos , Consenso , Colite Ulcerativa/terapia , Administração Tópica , Doença de Crohn/terapia , Resultado do Tratamento , Conferências de Consenso como Assunto , Espanha , Mesalamina/uso terapêutico , Budesonida/uso terapêutico , Triancinolona/uso terapêutico , Beclometasona/uso terapêutico , Hidrocortisona/uso terapêutico
14.
Arq Neuropsiquiatr ; 78(1): 50-52, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-32074188

RESUMO

Although headaches have recognized impact, there are no public policies in Brazil addressing this problem. The Brazilian Headache Society and the Brazilian Association of Cluster Headache and Migraine promoted a summit to discuss Public Policy and Advocacy for headache disorders. Professionals from various segments, representing various sectors of society, gathered in April 2019 in Brasília, defining the most important points for achieving advances in public policies in headache in Brazil, such as: inclusion in the chronic diseases surveillance agenda; improving public understanding and access to diagnosis and treatment; teaching in colleges and medical residences, structuring care networks, intervention models, clinical protocols and legislation supporting public policies in headache.


Assuntos
Conferências de Consenso como Assunto , Transtornos da Cefaleia Primários/terapia , Política Pública , Brasil , Humanos
16.
Am Heart J ; 219: 1-8, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31707323
18.
Artigo em Espanhol | IBECS | ID: ibc-186846

RESUMO

Este documento de consenso está elaborado por el área de Técnicas y Trasplante y el área de Enfermería de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR) así como la Sociedad Española de Endoscopia Respiratoria (AEER) con el objetivo de proporcionar conocimientos para el uso efectivo y seguro de la broncoscopia en pacientes con sospecha o con confirmación de la infección por COVID-19. Es prioritario proporcionar la mayor seguridad a nuestros pacientes, a los sanitarios que los atienden y a la comunidad en general. En este momento de pandemia, la información de la que disponemos acerca del uso de la broncoscopia en este tipo de pacientes se basa en la experiencia de otros centros y países, y las publicaciones científicas son escasas. El objetivo de este documento es recoger esas experiencias y en base a las recomendaciones de los organismos oficiales ofrecer un documento de ayuda para la práctica clínica diaria


This consensus document has been drawn up by the Techniques and Transplantation and Nursing areas of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Respiratory Endoscopy (AEER) with the aim of providing information on the safe and effective use of bronchoscopy in patients with suspected or confirmed COVID-19 infection. Our priority is to ensure the safety of our patients, the health workers caring for them, and the community in general.At this stage in the pandemic, our information on the use of bronchoscopy in patients of this type is based on the experience of hospitals in other countries, and scientific publications are scarce. The objective of this document isto compile these experiences, based on recommendations from official agencies, in a document offering guidance in daily clinical practice


Assuntos
Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Broncoscopia/normas , Broncoscopia/métodos , Equipamentos de Proteção/normas , Manejo de Espécimes/normas , Conferências de Consenso como Assunto , Sociedades Médicas , Espanha
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