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1.
J Glob Health ; 10(2): 020507, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33110590

RESUMO

Background: In a surgical setting, COVID-19 patients may trigger in-hospital outbreaks and have worse postoperative outcomes. Despite these risks, there have been no consistent statements on surgical guidelines regarding the perioperative screening or management of COVID-19 patients, and we do not have objective global data that describe the current conditions surrounding this issue. This study aimed to clarify the current global surgical practice including COVID-19 screening, preventive measures and in-hospital infection under the COVID-19 pandemic, and to clarify the international gaps on infection control policies among countries worldwide. Methods: During April 2-8, 2020, a cross-sectional online survey on surgical practice was distributed to surgeons worldwide through international surgical societies, social media and personal contacts. Main outcome and measures included preventive measures and screening policies of COVID-19 in surgical practice and centers' experiences of in-hospital COVID-19 infection. Data were analyzed by country's cumulative deaths number by April 8, 2020 (high risk, >5000; intermediate risk, 100-5000; low risk, <100). Results: A total of 936 centers in 71 countries responded to the survey (high risk, 330 centers; intermediate risk, 242 centers; low risk, 364 centers). In the majority (71.9%) of the centers, local guidelines recommended preoperative testing based on symptoms or suspicious radiologic findings. Universal testing for every surgical patient was recommended in only 18.4% of the centers. In-hospital COVID-19 infection was reported from 31.5% of the centers, with higher rates in higher risk countries (high risk, 53.6%; intermediate risk, 26.4%; low risk, 14.8%; P < 0.001). Of the 295 centers that experienced in-hospital COVID-19 infection, 122 (41.4%) failed to trace it and 58 (19.7%) reported the infection originating from asymptomatic patients/staff members. Higher risk countries adopted more preventive measures including universal testing, routine testing of hospital staff and use of dedicated personal protective equipment in operation theatres, but there were remarkable discrepancies across the countries. Conclusions: This large international survey captured the global surgical practice under the COVID-19 pandemic and highlighted the insufficient preoperative screening of COVID-19 in the current surgical practice. More intensive screening programs will be necessary particularly in severely affected countries/institutions. Study registration: Registered in ClinicalTrials.gov: NCT04344197.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Controle de Infecções/estatística & dados numéricos , Programas de Rastreamento/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Padrões de Prática Médica/estatística & dados numéricos , Procedimentos Cirúrgicos Operatórios/normas , Betacoronavirus , Infecções por Coronavirus/transmissão , Infecção Hospitalar/virologia , Estudos Transversais , Hospitais/normas , Hospitais/estatística & dados numéricos , Humanos , Controle de Infecções/normas , Programas de Rastreamento/normas , Pneumonia Viral/transmissão , Políticas , Padrões de Prática Médica/normas , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Inquéritos e Questionários
2.
Ann Ital Chir ; 91: 345-351, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33055390

RESUMO

INTRODUCTION: The recent Sars-CoV2 pandemic has dramatically slowed patients' access to our clinic for vascular pathology when the contagion curve peaked. The need to restore the assistance activity has led us to adopt new individual prophylaxis and hygiene measures. METHODS: Doctors and staff must wear dedicated clothes. Mask and gloves are mandatory for patients. A visit is scheduled every 60 minutes to allow the sanitation of the rooms. The day before the visit patients are contacted by telephone for the Covid-19 risk triage. In the presence of symptoms the visit is postponed. In the presence of other risk factors a IgG/IgM Rapid Test for Covid-19 is performed on admission to the clinic. In the presence of fever, if an extraordinary rapid test cannot be performed, the visit must be postponed. Rapid test positive patients cannot be visited: they are placed in solitary confinement at their home waiting for a nasopharyngeal swab for Covid-19. When the rapid test is positive, immediate room sanitation also occurs. The rooms dedicated to the outpatient clinic as well as medical and not medical instruments are disinfected. CONCLUSION: The one adopted can be a useful management model for any type of care activity in order to guarantee the safety of patients and all the staff. KEY WORDS: COVID-19, Management, vascular, Outpatient clinic.


Assuntos
Betacoronavirus , Cardiologia/organização & administração , Técnicas de Laboratório Clínico , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Ambulatório Hospitalar/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Anticorpos Antivirais/sangue , Agendamento de Consultas , Betacoronavirus/imunologia , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Desinfecção , Formulários como Assunto , Hospitais Universitários/organização & administração , Humanos , Higiene/normas , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Controle de Infecções/organização & administração , Controle de Infecções/normas , Itália/epidemiologia , Nasofaringe/virologia , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Avaliação de Sintomas , Termometria , Triagem/organização & administração
3.
WMJ ; 119(3): 202-204, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33091290

RESUMO

BACKGROUND: The COVID-19 pandemic has forced many practices to completely change the interface between health care providers and patients. Patients presenting with facial trauma present a special risk for COVID-19 transmission, as contact with respiratory and ocular secretions is common, and so special precautions must be taken in managing them. METHODS: We created guidelines and a triage/management algorithm for patients presenting with facial trauma to decrease the risk of COVID-19 transmission. CONCLUSIONS: In this paper, we present a set of guidelines and a triage algorithm we have successfully implemented to mitigate the spread of COVID-19 while managing facial trauma. We believe that these guidelines can help other providers restructure their practices during this pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Serviço Hospitalar de Emergência/normas , Traumatismos Faciais/terapia , Controle de Infecções/normas , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Triagem/normas , Algoritmos , Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Humanos , Telemedicina , Universidades , Wisconsin/epidemiologia
4.
Aust J Gen Pract ; 49(11): 728-732, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33123703

RESUMO

BACKGROUND: General practitioners (GPs) have some of the highest rates of mortality from COVID-19 among healthcare workers. SARS-CoV-2 has unique properties that place GPs at particular risk. OBJECTIVE: The aim of this article is to discuss the nose-related features of SARS-CoV-2 that place GPs at risk, and to make recommendations pertinent to the safety and protection of primary healthcare physicians. DISCUSSION: The highest viral load of SARS-CoV-2 is in the nose and nasopharynx. It is often highest early in the illness, before the development of symptoms. Further, SARS-CoV-2 replicates and continues to shed in the nasopharynx long after the virus is no longer detectable in the lower respiratory tract. This places any physician performing examinations on, or procedures involving, the upper respiratory tract at risk for contracting COVID-19. New-onset hyposmia and dysgeusia are indicators for COVID-19 and should be included in screening protocols.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Clínicos Gerais/estatística & dados numéricos , Controle de Infecções , Cavidade Nasal/virologia , Nasofaringe/virologia , Transtornos do Olfato/virologia , Pandemias , Pneumonia Viral , Austrália , Betacoronavirus/isolamento & purificação , Betacoronavirus/fisiologia , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Controle de Infecções/instrumentação , Controle de Infecções/métodos , Controle de Infecções/normas , Mucosa Nasal/metabolismo , Exposição Ocupacional/prevenção & controle , Exposição Ocupacional/estatística & dados numéricos , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Guias de Prática Clínica como Assunto , Atenção Primária à Saúde/normas , Gestão de Riscos , Carga Viral
6.
Rev Neurol ; 71(9): 340-350, 2020 11 01.
Artigo em Espanhol | MEDLINE | ID: mdl-33085079

RESUMO

At the end of January, the current outbreak of COVID-19 coronavirus disease was declared an important international public health emergency. In Spain, since the government declared the state of alarm on 14 March 2020, doctors responsible for carrying out neurophysiological tests have been performing them without any consensus criterion or clear safety guidelines for doctors, technicians or patients. The following recommendations, based on current knowledge of the disease and therefore liable to change in the future, are proposed when the pandemic appears to have entered a process of decreasing virulence and, with it, the strict containment measures established to date. However, in view of the possibility of a second wave of the pandemic, it seems necessary to establish basic and minimum recommendations to respect the patient's right to appropriate care, similar to that provided prior to the pandemic, and to maintain minimum safety standards for the patients themselves and for the doctors, technicians and health personnel carrying out these tests. These recommendations concern the constitution of a priority based on the reason for consultation, the establishment of calls to check the patient's clinical situation before going to the outpatient department and the rules for carrying out neurophysiological tests, which are generally based on the preservation of hospital circuits, respect for and observation of the known barriers to contagion of this disease, and the use of disposable material. These recommendations are of particular interest, especially given the uncertainty of not knowing the evolution of the SARS-CoV-2 infection in the coming weeks or months.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Eletrofisiologia , Controle de Infecções/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Assistência Ambulatorial , Continuidade da Assistência ao Paciente , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecção Hospitalar/prevenção & controle , Desinfecção , Eletrofisiologia/instrumentação , Eletrofisiologia/métodos , Eletrofisiologia/normas , Contaminação de Equipamentos , Humanos , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Pacientes Internados , Monitorização Intraoperatória , Exposição Ocupacional , Equipamento de Proteção Individual , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Utilização de Procedimentos e Técnicas , Espanha/epidemiologia , Avaliação de Sintomas , Telemedicina
7.
Can J Surg ; 63(5): E393-E394, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33009900

RESUMO

SUMMARY: The impact of waiting for surgery on the mental health of patients usually receives little attention. Because of the coronavirus disease 2019 (COVID-19) pandemic, the waits for elective surgery have been lengthening, potentially inducing or exacerbating mental health burdens. Provinces' health systems need to provide better support to assess not only patients' physical health, but also their mental health, and provide them with timely access to care based on need. A stepped care approach is needed to mitigate negative mental health effects associated with prolonged waits for elective operations. To provide the best care possible, we need to recognize and address both the physical and mental health problems of our waiting patients.


Assuntos
Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos Eletivos/psicologia , Controle de Infecções/normas , Saúde Mental , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Cuidados Pré-Operatórios/métodos , Betacoronavirus/patogenicidade , Canadá/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Procedimentos Cirúrgicos Eletivos/normas , Acesso aos Serviços de Saúde/normas , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Fatores de Tempo , Tempo para o Tratamento , Listas de Espera
8.
Can J Surg ; 63(5): E418-E421, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33009901

RESUMO

SUMMARY: The Canadian Network for International Surgery (CNIS) hosted a workshop in May of 2020 with a goal of critically evaluating Trauma Team Training courses. The workshop was held virtually because of the coronavirus disease 2019 (COVID-19) pandemic. Twenty-three participants attended from 8 countries: Canada, Guyana, Kenya, Nigeria, Switzerland, Tanzania, Uganda and the United States. More participants were able to attend the virtual meeting than the traditional in-person meetings. Web-based videoconference software was used, participants presented prerecorded PowerPoint videos, and questions were raised using a written chat. The review proved successful, with discussions and recommendations for improvements surrounding course quality, lecture content, skills sessions, curriculum variations and clinical practical scenarios. The CNIS's successful experience conducting an online curriculum review involving international participants may prove useful to others proceeding with collaborative projects during the COVID-19 pandemic.


Assuntos
Congressos como Assunto/organização & administração , Infecções por Coronavirus/prevenção & controle , Currículo , Cirurgia Geral/educação , Cooperação Internacional , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus/patogenicidade , Canadá/epidemiologia , Congressos como Assunto/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Cirurgia Geral/métodos , Guiana/epidemiologia , Humanos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Quênia/epidemiologia , Nigéria/epidemiologia , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Suíça/epidemiologia , Tanzânia/epidemiologia , Uganda/epidemiologia , Estados Unidos/epidemiologia , Comunicação por Videoconferência/organização & administração , Comunicação por Videoconferência/normas , Ferimentos e Lesões/cirurgia
9.
J Crohns Colitis ; 14(Supplement_3): S791-S797, 2020 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-33085973

RESUMO

Endoscopy is an essential component in the management of inflammatory bowel disease [IBD]. There is a risk of SARS-CoV-2 transmission during endoscopic procedures. The International Organization for the study of IBD [IOIBD] has developed 11 position statements, based on an online survey, that focus on how to prioritise endoscopies in IBD patients during the COVID-19 pandemic, alternative modes for disease monitoring, and ways to triage the high number of postponed endoscopies after the pandemic. We propose to pre-screen patients for suspected or confirmed COVID-19 and test for SARS-CoV-2 before endoscopy if available. High priority endoscopies during pandemic include acute gastrointestinal bleed, acute severe ulcerative colitis, new IBD diagnosis, cholangitis in primary sclerosing cholangitis, and partial bowel obstruction. Alternative modes of monitoring using clinical symptoms, serum inflammatory markers, and faecal calprotectin should be considered during the pandemic. Prioritising access to endoscopy in the post-pandemic period should be guided by control of COVID-19 in the local community and availability of manpower and personal protective equipment. Endoscopy should be considered within 3 months after the pandemic for patients with a past history of dysplasia and endoscopic resection for dysplastic lesion. Endoscopy should be considered 3-6 months after the pandemic for assessment of postoperative recurrence or new biologic initiation. Endoscopy can be postponed until after 6 months of pandemic for routine IBD surveillance and assessment of mucosal healing.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Endoscopia Gastrointestinal/normas , Alocação de Recursos para a Atenção à Saúde/normas , Controle de Infecções/normas , Doenças Inflamatórias Intestinais/diagnóstico por imagem , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Triagem/normas , Técnicas de Laboratório Clínico/normas , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Endoscopia Gastrointestinal/métodos , Saúde Global , Alocação de Recursos para a Atenção à Saúde/métodos , Acesso aos Serviços de Saúde/normas , Humanos , Controle de Infecções/métodos , Doenças Inflamatórias Intestinais/complicações , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Triagem/métodos
10.
Infect Dis Poverty ; 9(1): 141, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33046120

RESUMO

In the past five months, success in control the national epidemic of coronavirus disease 2019 (COVID-19) has been witnessed in China. The implementation of public health measures accounts for the success which include different interventions in the early or later stages of the outbreak. It is clear that although not all measures were universally effective worldwide, their achievements have been significant. More solidarity is needed to deal with this global pandemic with more learning and understanding. Understanding which of the public health interventions implemented in China were effective may provide ideas for international epidemic control.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública/métodos , Betacoronavirus/isolamento & purificação , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa/prevenção & controle , Diagnóstico Precoce , Humanos , Controle de Infecções/normas , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Saúde Pública/normas
13.
J Immunother Cancer ; 8(2)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33060148

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has overwhelmed the health systems worldwide. Data regarding the impact of COVID-19 on cancer patients (CPs) undergoing or candidate for immune checkpoint inhibitors (ICIs) are lacking. We depicted the practice and adaptations in the management of patients with solid tumors eligible or receiving ICIs during the COVID-19 pandemic, with a special focus on Campania region. METHODS: This survey (25 questions), promoted by the young section of SCITO (Società Campana di ImmunoTerapia Oncologica) Group, was circulated among Italian young oncologists practicing in regions variously affected by the pandemic: high (group 1), medium (group 2) and low (group 3) prevalence of SARS-CoV-2-positive patients. For Campania region, the physician responders were split into those working in cancer centers (CC), university hospitals (UH) and general hospitals (GH). Percentages of agreement, among High (H) versus Medium (M) and versus Low (L) group for Italy and among CC, UH and GH for Campania region, were compared by using Fisher's exact tests for dichotomous answers and χ2 test for trends relative to the questions with 3 or more options. RESULTS: This is the first Italian study to investigate the COVID-19 impact on cancer immunotherapy, unique in its type and very clear in the results. The COVID-19 pandemic seemed not to affect the standard practice in the prescription and delivery of ICIs in Italy. Telemedicine was widely used. There was high consensus to interrupt immunotherapy in SARS-CoV-2-positive patients and to adopt ICIs with longer schedule interval. The majority of the responders tended not to delay the start of ICIs; there were no changes in supportive treatments, but some of the physicians opted for delaying surgeries (if part of patients' planned treatment approach). The results from responders in Campania did not differ significantly from the national ones. CONCLUSION: Our study highlights the efforts of Italian oncologists to maintain high standards of care for CPs treated with ICIs, regardless the regional prevalence of COVID-19, suggesting the adoption of similar solutions. Research on patients treated with ICIs and experiencing COVID-19 will clarify the safety profile to continue the treatments, thus informing on the most appropriate clinical conducts.


Assuntos
Antineoplásicos Imunológicos/administração & dosagem , Betacoronavirus/imunologia , Infecções por Coronavirus/epidemiologia , Oncologia/estatística & dados numéricos , Neoplasias/tratamento farmacológico , Pneumonia Viral/epidemiologia , Adulto , Antineoplásicos Imunológicos/efeitos adversos , Antígeno B7-H1/antagonistas & inibidores , Antígeno B7-H1/imunologia , Betacoronavirus/patogenicidade , Antígeno CTLA-4/antagonistas & inibidores , Antígeno CTLA-4/imunologia , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Prescrições de Medicamentos/estatística & dados numéricos , Feminino , Geografia , Humanos , Controle de Infecções/normas , Itália/epidemiologia , Masculino , Oncologia/normas , Neoplasias/imunologia , Oncologistas/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/imunologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Padrões de Prática Médica/normas , Padrões de Prática Médica/estatística & dados numéricos , Prevalência , Receptor de Morte Celular Programada 1/antagonistas & inibidores , Receptor de Morte Celular Programada 1/imunologia , Inquéritos e Questionários/estatística & dados numéricos , Tempo para o Tratamento
14.
Ann Glob Health ; 86(1): 129, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-33102149

RESUMO

In August 2017, Bangladesh saw a massive influx of Rohingya refugees following their violent persecution by the Myanmar authorities. Since then, the district of Cox's Bazar has been home to nearly 900,000 Rohingya refugees living in the densely populated and unhygienic camps. The refugees have been living in makeshift settlements which are cramped into one another, making it extremely difficult to maintain "social distance". The overcrowded conditions coupled with the low literacy level, lack of basic sanitation facilities, face masks and gloves and limited communication make these camps an ideal place for the virus to spread rapidly. As nations struggle to contain the SARS-CoV-2 virus, refugees are one such population who are extremely vulnerable to the effects of this outbreak. If issues are not addressed at an early stage, its effects can be catastrophic.


Assuntos
Infecções por Coronavirus , Aglomeração , Transmissão de Doença Infecciosa/prevenção & controle , Controle de Infecções , Pandemias , Pneumonia Viral , Campos de Refugiados , Refugiados/estatística & dados numéricos , Bangladesh/epidemiologia , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Acesso aos Serviços de Saúde/normas , Necessidades e Demandas de Serviços de Saúde , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Mianmar/epidemiologia , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Campos de Refugiados/normas , Campos de Refugiados/provisão & distribução , Saneamento/normas
15.
JCO Glob Oncol ; 6: 1494-1509, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33017179

RESUMO

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has had a global impact, and Singapore has seen 33,000 confirmed cases. Patients with cancer, their caregivers, and health care workers (HCWs) need to balance the challenges associated with COVID-19 while ensuring that cancer care is not compromised. This study aimed to evaluate the psychological effect of COVID-19 on these groups and the prevalence of burnout among HCWs. METHODS: A cross-sectional survey of patients, caregivers, and HCWs at the National Cancer Centre Singapore was performed over 17 days during the lockdown. The Generalized Anxiety Disorder-7 and Maslach Burnout Inventory were used to assess for anxiety and burnout, respectively. Self-reported fears related to COVID-19 were collected. RESULTS: A total of 624 patients, 408 caregivers, and 421 HCWs participated in the study, with a response rate of 84%, 88%, and 92% respectively. Sixty-six percent of patients, 72.8% of caregivers, and 41.6% of HCWs reported a high level of fear from COVID-19. The top concern of patients was the wide community spread of COVID-19. Caregivers were primarily worried about patients dying alone. HCWs were most worried about the relatively mild symptoms of COVID-19. The prevalence of anxiety was 19.1%, 22.5%, and 14.0% for patients, caregivers, and HCWs, respectively. Patients who were nongraduates and married, and caregivers who were married were more anxious. The prevalence of burnout in HCWs was 43.5%, with more anxious and fearful HCWs reporting higher burnout rates. CONCLUSION: Fears and anxiety related to COVID-19 are high. Burnout among HCWs is similar to rates reported prepandemic. An individualized approach to target the specific fears of each group will be crucial to maintain the well-being of these vulnerable groups and prevent burnout of HCWs.


Assuntos
Ansiedade/epidemiologia , Esgotamento Profissional/epidemiologia , Cuidadores/psicologia , Infecções por Coronavirus/psicologia , Neoplasias/psicologia , Pneumonia Viral/psicologia , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/psicologia , Betacoronavirus/patogenicidade , Esgotamento Profissional/diagnóstico , Esgotamento Profissional/psicologia , Institutos de Câncer/organização & administração , Institutos de Câncer/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Estudos Transversais , Medo/psicologia , Feminino , Pessoal de Saúde/psicologia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/normas , Humanos , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Masculino , Oncologia/organização & administração , Oncologia/normas , Pessoa de Meia-Idade , Neoplasias/terapia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Prevalência , Singapura/epidemiologia , Carga de Trabalho/psicologia
16.
J Cancer Res Ther ; 16(5): 974-978, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33004737

RESUMO

The pandemic of coronavirus disease 2019 (COVID-19) has become a major public health threat to the whole world. Although the control of COVID-19 has been in the forefront of interventional practice, most interventional radiologists (IRs) are not equipped adequately to cope with such a crisis. In this review, we share our experience from Chinese IRs' perspective, report on the acute measures instituted within interventional radiology (IR) units, and give recommendations to the prevention and control of COVID-19.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/normas , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , Pneumonia Viral/prevenção & controle , Padrões de Prática Médica/normas , Radiologia Intervencionista/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Humanos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Radiologia Intervencionista/instrumentação
17.
Eur J Obstet Gynecol Reprod Biol ; 253: 133-140, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32866856

RESUMO

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has raised some important interrogations on minimally invasive gynaecological surgery. The International Society for Gynecologic Endoscopy (ISGE) has taken upon itself the task of providing guidance and best practice policies for all practicing gynaecological endoscopists. Factors affecting decision making processes in minimal invasive surgery (MIS) vary depending on factors such as the phase of the pandemic, policies on control and prevention, expertise and existing infrastructure. Our responsibility remains ensuring the safety of all health care providers, ancillary staff and patients during this unusual period. We reviewed the current literature related to gynecological and endoscopic surgery during the Coronavirus Disease 19 (COVID-19) crisis. Regarding elective surgery, universal testing for SARS-CoV-2 infection should be carried out wherever possible 40 h prior to surgery. In case of confirmed positive case of SARS-CoV-2, surgery should be delayed. Priority should be given to relatively urgent cases such as malignancies. ISGE supports medical optimization and delaying surgery for benign non-life-threatening surgeries. When possible, we recommend to perform cases by laparoscopy and to allow early discharges. Any procedure with risk of bowel involvement should be performed by open surgery as studies have found a high amount of viral RNA (ribonucleic acid) in stool. Regarding urgent surgery, each unit should create a risk assessment flow chart based on capacity. Patients should be screened for symptoms and symptomatic patients must be tested. In the event that a confirmed case of SARS-CoV-2 is found, every attempt should be made to optimize medical management and defer surgery until the patient has recovered and only emergency or life-threatening surgery should be performed in these cases. We recommend to avoid intubation and ventilation in SARS-CoV-2 positive patients and if at all possible local or regional anesthesia should be utilized. Patients who screen or test negative may have general anesthesia and laparoscopic surgery while strict protocols of infection control are upheld. Surgery in screen-positive as well as SARS-CoV-2 positive patients that cannot be safely postponed should be undertaken with full PPE with ensuring that only essential personnel are exposed. If available, negative pressure theatres should be used for patients who are positive or screen high risk. During open and vaginal procedures, suction can be used to minimize droplet and bioaerosol spread. In a patient who screens low risk or tests negative, although carrier and false negatives cannot be excluded, laparoscopy should be strongly considered. We recommend, during minimal access surgeries, to use strategies to reduce production of bioaerosols (such as minimal use of energy, experienced surgeon), to reduce leakage of smoke aerosols (for example, minimizing the number of ports used and size of incisions, as well as reducing the operating pressures) and to promote safe elimination of smoke during surgery and during the ports' closure (such as using gas filters and smoke evacuation systems). During the post-peak period of pandemic, debriefing and mental health screening for staff is recommended. Psychological support should be provided as needed. In conclusion, based on the existent evidence, ISGE largely supports the current international trends favoring laparoscopy over laparotomy on a case by case risk evaluation basis, recognizing the different levels of skill and access to minimally invasive procedures across various countries.


Assuntos
Infecções por Coronavirus/prevenção & controle , Endoscopia/normas , Procedimentos Cirúrgicos em Ginecologia/normas , Controle de Infecções/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Betacoronavirus , Infecções por Coronavirus/etiologia , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Procedimentos Cirúrgicos Eletivos/normas , Feminino , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Humanos , Pneumonia Viral/etiologia , Sociedades Médicas
18.
Ann Glob Health ; 86(1): 100, 2020 08 13.
Artigo em Inglês | MEDLINE | ID: mdl-32864352

RESUMO

Background: Brazil faces some challenges in the battle against the COVID-19 pandemic, including: the risks for cross-infection (community infection) increase in densely populated areas; low access to health services in areas where the number of beds in intensive care units (ICUs) is scarce and poorly distributed, mainly in states with low population density. Objective: To describe and intercorrelate epidemiology and geographic data from Brazil about the number of intensive care unit (ICU) beds at the onset of COVID-19 pandemic. Methods: The epidemiology and geographic data were correlated with the distribution of ICU beds (public and private health systems) and the number of beneficiaries of private health insurance using Pearson's Correlation Coefficient. The same data were correlated using partial correlation controlled by gross domestic product (GDP) and number of beneficiaries of private health insurance. Findings: Brazil has a large geographical area and diverse demographic and economic aspects. This diversity is also present in the states and the Federal District regarding the number of COVID-19 cases, deaths and case fatality rate. The effective management of severe COVID-19 patients requires ICU services, and the scenario was also dissimilar as for ICU beds and ICU beds/10,000 inhabitants for the public (SUS) and private health systems mainly at the onset of COVID-19 pandemic. The distribution of ICUs was uneven between public and private services, and most patients rely on SUS, which had the lowest number of ICU beds. In only a few states, the number of ICU beds at SUS was above 1 to 3 by 10,000 inhabitants, which is the number recommended by the World Health Organization (WHO). Conclusions: Brazil needed to improve the number of ICU beds units to deal with COVID-19 pandemic, mainly for the SUS showing a late involvement of government and health authorities to deal with the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus , Acesso aos Serviços de Saúde/organização & administração , Unidades de Terapia Intensiva/provisão & distribução , Pandemias , Administração dos Cuidados ao Paciente , Pneumonia Viral , Setor Privado/estatística & dados numéricos , Setor Público/estatística & dados numéricos , Ocupação de Leitos/estatística & dados numéricos , Betacoronavirus , Brasil/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Necessidades e Demandas de Serviços de Saúde , Humanos , Controle de Infecções/organização & administração , Controle de Infecções/normas , Inovação Organizacional , Pandemias/prevenção & controle , Administração dos Cuidados ao Paciente/organização & administração , Administração dos Cuidados ao Paciente/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Índice de Gravidade de Doença
19.
Cancer Cytopathol ; 128(9): 597-598, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32885911
20.
Ultrasound Q ; 36(3): 200-205, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32890322

RESUMO

The coronavirus disease 2019 is caused by the severe acute respiratory syndrome coronavirus 2. The virus can be spread by close person-to-person contact primarily by respiratory droplets. Given the close proximity of the sonographer or sonologist with the patient during ultrasound examinations, special precautions should be taken to limit the exposure of radiology personnel to patients with coronavirus disease 2019 while still providing optimal patient care. Methods covered in this article include modified workflow, close scrutiny and prioritization of imaging orders, and design of targeted ultrasound protocols. These guidelines summarize the personal experience and insight of multiple colleagues who lead ultrasound sections or are experts in the field.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Serviço Hospitalar de Radiologia/normas , Ultrassonografia Doppler/normas , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Masculino , Saúde do Trabalhador , Avaliação de Resultados em Cuidados de Saúde , Pandemias/estatística & dados numéricos , Segurança do Paciente/estatística & dados numéricos , Pneumonia Viral/epidemiologia
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