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2.
BMC Infect Dis ; 20(1): 734, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028245

RESUMO

BACKGROUND: HIV continues to be the main determinant morbidity with high mortality rates in Sub-Saharan Africa, with a high number of patients being late presenters with advanced HIV. Clinical management of advanced HIV patients is thus complex and requires strict adherence to updated, empirical and simplified guidelines. The current study investigated the impact of the implementation of a new clinical guideline on the management of advanced HIV in Kinshasa, Democratic Republic of Congo (DRC). METHODS: A retrospective analysis of routine clinical data of advanced HIV patients was conducted for the periods; February 2016 to March 2017, before implementation of new guidelines, and November 2017 to July 2018, after the implementation of new guidelines. Eligible patients were patients with CD4 < 200 cell/µl and presenting with at least 1 of 4 opportunistic infections. Patient files were reviewed by a medical doctor and a committee of 3 other doctors for congruence. Statistical significance was set at 0.05%. RESULTS: Two hundred four and Two hundred thirty-one patients were eligible for inclusion before and after the implementation of new guidelines respectively. Sex and age distributions were similar for both periods, and median CD4 were 36 & 52 cell/µl, before and after the new guidelines implementation, respectively. 40.7% of patients had at least 1 missed/incorrect diagnosis before the new guidelines compared to 30% after new guidelines, p < 0.05. Clinical diagnosis for TB and toxoplasmosis were also much improved after the implementation of new guidelines. In addition, only 63% of patients had CD4 count test results before the new guidelines compared to 99% of patients after new guidelines. Death odds after the implementation of new guidelines were significantly lower than before new guidelines in a multivariate regression model that included patients CD4 count and 10 other covariates, p < 0.05. CONCLUSIONS: Simplification and implementation of a new and improved HIV clinical guideline coupled with the installation of laboratory equipment and point of care tests potentially helped reduce incorrect diagnosis and improve clinical outcomes of patients with advanced HIV. Regulating authorities should consider developing simplified versions of guidelines followed by the provision of basic diagnostic equipment to health centers.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Contagem de Linfócito CD4 , República Democrática do Congo , Feminino , Guias como Assunto , Infecções por HIV/complicações , Infecções por HIV/mortalidade , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Toxoplasmose/complicações , Toxoplasmose/diagnóstico , Tuberculose/complicações , Tuberculose/diagnóstico , Adulto Jovem
3.
Lima; Perú. Ministerio de Salud; 1 ed; 20200900. 9 p. ilus.
Monografia em Espanhol | LILACS, MINSAPERU | ID: biblio-1121873

RESUMO

La publicación describe las pautas metodológicas como parte del acompañamiento psicosocial que se le brinda a una persona en estado de crisis; también contiene estrategias de afrontamiento funcionales frente a la crisis, es decir, desarrollar o fortalecer aquellos modos de pensar y actuar que facilitan la resolución de una situación percibida como demandante.


Assuntos
Adaptação Psicológica , Saúde Mental , Guias como Assunto , Assistência Integral à Saúde , Primeiros Socorros
4.
Lima; Perú. Ministerio de Salud; 20200900. 30 p.
Monografia em Espanhol | LILACS, MINSAPERU | ID: biblio-1118686

RESUMO

El documento contiene los criterios administrativos para el adecuado tratamiento de los datos personales relacionados con la salud o datos personales en salud.


Assuntos
Sistemas de Informação , Registros Médicos , Segurança Computacional , Guias como Assunto
6.
Lancet Oncol ; 21(9): e444-e451, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32888473

RESUMO

Population-based cancer registries (PBCRs) generate measures of cancer incidence and survival that are essential for cancer surveillance, research, and cancer control strategies. In 2014, the Toronto Paediatric Cancer Stage Guidelines were developed to standardise how PBCRs collect data on the stage at diagnosis for childhood cancer cases. These guidelines have been implemented in multiple jurisdictions worldwide to facilitate international comparative studies of incidence and outcome. Robust stratification by risk also requires data on key non-stage prognosticators (NSPs). Key experts and stakeholders used a modified Delphi approach to establish principles guiding paediatric cancer NSP data collection. With the use of these principles, recommendations were made on which NSPs should be collected for the major malignancies in children. The 2014 Toronto Stage Guidelines were also reviewed and updated where necessary. Wide adoption of the resultant Paediatric NSP Guidelines and updated Toronto Stage Guidelines will enhance the harmonisation and use of childhood cancer data provided by PBCRs.


Assuntos
Guias como Assunto/normas , Neoplasias/terapia , Pediatria/tendências , Prognóstico , Criança , Assistência à Saúde , Humanos , Estadiamento de Neoplasias , Neoplasias/epidemiologia , Sistema de Registros
7.
Diving Hyperb Med ; 50(3): 278-287, 2020 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-32957131

RESUMO

Scuba diving is a critical activity for commercial industry, military activities, research, and public safety, as well as a passion for many recreational divers. Physicians are expected to provide return-to-diving recommendations after SARS-CoV-2 (COVID-19) infection based upon the best available evidence, often drawn from experience with other, similar diseases. Scuba diving presents unique physiologic challenges to the body secondary to immersion, increased pressure and increased work of breathing. The long-term sequelae of COVID-19 are still unknown, but if they are proven to be similar to other coronaviruses (such as Middle East respiratory syndrome or SARS-CoV-1) they may result in long-term pulmonary and cardiac sequelae that impact divers' ability to safely return to scuba diving. This review considers available literature and the pathophysiology of COVID-19 as it relates to diving fitness, including current recommendations for similar illnesses, and proposes guidelines for evaluation of divers after COVID-19. The guidelines are based upon best available evidence about COVID-19, as well as past experience with determination of diving fitness. It is likely that all divers who have contracted COVID-19 will require a medical evaluation prior to return to diving with emphasis upon pulmonary and cardiac function as well as exercise capacity.


Assuntos
Infecções por Coronavirus/complicações , Mergulho , Guias como Assunto , Pneumonia Viral/complicações , Retorno ao Trabalho , Betacoronavirus , Humanos , Pandemias
8.
Acta Biomed ; 91(3): e2020028, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32921723

RESUMO

This article reviews the current knowledges of congenital bleeding disorders (CBD) amid the COVID-19 pandemic. It appears that CBD is not associated with higher risk of getting COVID-19 and so the prevalence of COVID-19 among them seems not higher compared to the general population. In absence of specific therapeutic recommendations, it is essential to make a correct assessment of the risk of haemorrhage/thrombosis. Based on expert opinion, strategies for outpatient management include adherence to prescribed regimens, telemedicine, and communication about COVID-19 in patients with CBD. More data should be also collected to better characterize the impact of COVID-19 on patients with CBD. The current findings encourage further studies to determine the prevalence of SARS-CoV2 infection in CBD patients to understand more fully the burden of this novel pathogen and to develop adequate preventive measures against this infection.


Assuntos
Betacoronavirus , Transtornos Herdados da Coagulação Sanguínea/epidemiologia , Infecções por Coronavirus/epidemiologia , Gerenciamento Clínico , Guias como Assunto , Pandemias , Pneumonia Viral/epidemiologia , Telemedicina/métodos , Transtornos Herdados da Coagulação Sanguínea/terapia , Humanos , Pacientes Ambulatoriais
9.
S Afr Med J ; 110(7): 635-639, 2020 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-32880338

RESUMO

Research is imperative in addressing the COVID-19 epidemic, both in the short and long term. Informed consent is a key pillar of research and should be central to the conduct of COVID-19 research. Yet a range of factors, including physical distancing requirements, risk of exposure and infection to research staff, and multiple pressures on the healthcare environment, have added layers of challenges to the consent process in COVID-19 patients. Internationally, the recognition that consent for COVID-19 research may be imperfect has led to a range of suggestions to ensure that research remains ethical. Drawing on these guidelines, we propose a consent process for COVID-19 research in the South African context that combines individual consent with delayed and proxy consent for individuals who may be temporarily incapacitated, combined with key principles that should be considered in the design of a consent process for COVID-19 research.


Assuntos
Infecções por Coronavirus/epidemiologia , Bases de Dados Factuais/ética , Guias como Assunto , Consentimento Livre e Esclarecido/ética , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Controle de Doenças Transmissíveis/normas , Infecções por Coronavirus/prevenção & controle , Países em Desenvolvimento , Feminino , Humanos , Masculino , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Projetos de Pesquisa , África do Sul
13.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1192-1194, 2020 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-32867423

RESUMO

As an emerging infectious disease, the COVID-19 threatened the safety of personnel in the prevention and control during the COVID-19 pandemic. Beijing Association of Preventive Medicine organizes the Beijing CDC and other organizations drafted the group standard entitled "Guidelines for personal protection against coronavirus disease 2019 for diseases control person (T/BPMA 0002-2020)" , according to years of scientific research on personal protection. Based on the principles of emphasizing the scientific, normative and safe nature, the standard was drafted to put forward the reasonable selection and correct use of personal protective equipment for disease control personnel, as well as the procedures for personal protective equipment. The standard provided a standardized basis for ensuring the safety of disease control personnel in contacting and handling of the new coronary pneumonia outbreaks with high risks.


Assuntos
Infecções por Coronavirus/prevenção & controle , Coronavirus , Guias como Assunto , Controle de Infecções/normas , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , Pneumonia Viral/prevenção & controle , Betacoronavirus , China , Infecções por Coronavirus/epidemiologia , Pessoal de Saúde , Humanos , Controle de Infecções/métodos , Pneumonia Viral/epidemiologia
15.
Hosp. domic ; 4(3): 133-152, jul.-sept. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192943

RESUMO

PROPÓSITO: Ante la crisis sanitaria que vive el país y el mundo actualmente, se confeccionó este documento por la iniciativa autónoma de kinesiólogos de doce unidades de Hospitalización Domiciliaria (HD) de hospitales públicos de Chile, con el fin de unificar criterios en base a sus experiencias y la evidencia científica disponible para poder realizar una atención kinésica respiratoria segura en pacientes con sospecha o confirmados para COVID-19. Además, este documento tiene el objetivo de ser una guía para quienes tengan la necesidad de protocolizar y/o estandarizar su atención en HD, pudiendo ser adaptado según la necesidad y disponibilidad de recursos e infraestructura de cada unidad. Es importante señalar, que este documento puede variar según la evolución de esta pandemia y la actualización de la evidencia científica. CAMPO DE APLICACIÓN: Este documento está diseñado para ser aplicado en el domicilio de los pacientes adultos y pediátricos ingresados a las Unidades de Hospitalización Domiciliaria (UHD) con sospecha de infección por SARS-CoV-2 o con resultado positivo para COVID-19


PURPUSE: Given the health crisis that the country and the world are currently experiencing, this document was prepared by the autonomous initiative of kinesiologists from twelve Hospital at Home units of public hospitals in Chile, in order to unify criteria based on their experiences and the available scientific evidence in order to carry out safe respiratory physiotherapy care in patients with suspected or confirmed COVID-19. In addition, this document is intended to be a guide for those who need to protocolize and / or standardize their care at Hospital at home, and can be adapted according to the need and availability of resources and infrastructure of each unit. It is important to note that this document may vary depending on the evolution of this pandemic and the updating of scientific evidence. SCOPE: This document is designed to be applied in the home of adult and pediatric patients admitted to Hospital at Home Units (UHD) with suspected SARS-CoV-2 infection or with a positive result for COVID-19


Assuntos
Humanos , Exercícios Respiratórios/métodos , Síndrome Respiratória Aguda Grave/reabilitação , Vírus da SARS/patogenicidade , Infecções por Coronavirus/epidemiologia , Modalidades de Fisioterapia/organização & administração , Serviços Hospitalares de Assistência Domiciliar/organização & administração , Controle de Doenças Transmissíveis/métodos , Ventilação não Invasiva/estatística & dados numéricos , Precauções Universais/métodos , Guias como Assunto
16.
Radiographics ; 40(5): 1309-1317, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870768

RESUMO

The recent shutting down of in-person events owing to the coronavirus disease 2019 (COVID-19) pandemic has elevated the popularity of web-based conferencing. This development provides an opportunity for educators to test their teaching skills on what, for many, is a new platform. Many of the basic elements of what constitutes an effective presentation are the same regardless of whether they are delivered in person or online. However, there are advantages and disadvantages of each mode of presentation, and understanding how to best leverage the features of an online platform will lead to a better educational experience for the presenter and audience. The effectiveness of any presentation is dependent on the ability of the speaker to communicate with the audience. This is accomplished by including as much audience participation as possible. Many of the techniques used to encourage audience participation in person can be adapted for use in online presentations (eg, the use of features such as chat, hand raising, polling, and question-and-answer sessions). In any type of presentation, both the quality of the content and the oral delivery are important. The author reviews the common elements of an effective presentation and how they can be optimized for online platforms. ©RSNA, 2020.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Internet , Pandemias , Pneumonia Viral , Radiologia/métodos , Comunicação por Videoconferência , Infecções por Coronavirus/prevenção & controle , Apresentação de Dados , Guias como Assunto , Humanos , Marketing , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Radiologia/tendências , Fala , Comunicação por Videoconferência/organização & administração , Comunicação por Videoconferência/tendências
17.
Health Lit Res Pract ; 4(3): e161-e165, 2020 08 06.
Artigo em Inglês | MEDLINE | ID: mdl-32926171

RESUMO

Stay-at-home orders have been an essential component of coronavirus 2019 (COVID-19) management in the United States. As states start lifting these mandates to reopen the economy, voluntary public compliance with public health recommendations may significantly influence the extent of resurgence in COVID-19 infection rates. Population-level risk from reopening may therefore be predicted from public intent to comply with public health recommendations. We are conducting a global, convergent design mixed-methods survey on public knowledge, perceptions, preferred health information sources, and understanding of and intent to comply with public health recommendations. With over 9,000 completed surveys from every US state and over 70 countries worldwide, to our knowledge this is the largest pandemic messaging study to date. Although the study is still ongoing, we have conducted an analysis of 5,005 US surveys completed from April 9-15, 2020 on public intent to comply with public health recommendations and offer insights on the COVID-19 pandemic-related risk of reopening. We found marked regional differences in intent to follow key public health recommendations. Regional efforts are urgently needed to influence public behavior changes to decrease the risk of reopening, particularly in higher-risk areas with low public intent to comply with preventive health recommendations. [HLRP: Health Literacy Research and Practice. 2020;4(3):e160-e165.].


Assuntos
Atitude Frente a Saúde , Infecções por Coronavirus/prevenção & controle , Intenção , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública , Comportamento Social , Adulto , Betacoronavirus , Comunicação , Coronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Feminino , Guias como Assunto , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Isolamento Social , Inquéritos e Questionários , Estados Unidos
18.
Health Lit Res Pract ; 4(3): e166-e170, 2020 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-32926172

RESUMO

By mid-May 2020, most of the United States had been under shelter-in-place orders for several weeks to decrease the spread of coronavirus 2019 (COVID-19). As states begin to lift these orders to reopen the economy, the risk of a resurgence of COVID-19 may be related to the public's voluntary adherence to public health recommendations. We conducted a nationally representative survey of 604 African Americans to generate a risk assessment based on African Americans' compliance with public health recommendations to frequently wash hands, maintain social distancing, avoid touching face, and wear a mask in public. This is, to our knowledge, the most comprehensive study of African Americans and public health adherence specific to COVID-19. The percent of respondents reporting that they always comply with these recommendations was 72%, 67%, 55%, and 65%, respectively. Based on this threshold, African Americans' level of adherence with COVID-19 public health recommendations suggests they may be at high risk of a resurgence of COVID-19 during reopening, and there is an urgent need for targeted, culturally responsive public health messaging that is accessible to communities of color to help address racial disparities in COVID-19 risk. [HLRP: Health Literacy Research and Practice. 2020;4(3):e166-e170.].


Assuntos
Afro-Americanos , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Saúde Pública , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Face , Feminino , Guias como Assunto , Desinfecção das Mãos , Humanos , Masculino , Máscaras , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Medição de Risco , Isolamento Social , Estados Unidos
20.
Work ; 66(4): 713-716, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32925132

RESUMO

BACKGROUND: The primary response to the coronavirus (COVID-19) pandemic has been to minimize social contact through lockdown measures. The closure of non-essential businesses to tackle the spread of the coronavirus has had negative consequences for the global economy, production, and employment. OBJECTIVE: To outline how known occupational health principles can be used for preventative management of the coronavirus in workplaces to support resumption of work. METHODS: A discussion of current knowledge of COVID-19, the cost of the lockdown strategy, and preventative biological cycle management. RESULTS: The evidence-based literature indicates that biological cycle management can control the risk of coronavirus infection, provide a suitable and sufficient exit strategy from lockdown, and support getting employees back to work. Adherence to personal protective equipment standards has been insufficient, indicating a need for workplace investment and education. CONCLUSION: Imposed restrictions on workplace operations can be lifted without compromising worker health and safety when a workplace commits to practicing the three principles of biological cycle management.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/prevenção & controle , Saúde do Trabalhador , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Quarentena/normas , Retorno ao Trabalho , Local de Trabalho/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Guias como Assunto , Higiene das Mãos/normas , Humanos , Equipamento de Proteção Individual/normas , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Quarentena/organização & administração , Fatores de Tempo
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