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1.
PLoS One ; 15(8): e0238416, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32857826

RESUMO

Fangcang shelter hospitals were established in China during the coronavirus disease 2019 (COVID-19) pandemic as a countermeasure to stop the spread of the disease. To our knowledge, no research has been conducted on mental health problems among patients in Fangcang shelter hospitals. This study aimed to determine the prevalence and major influencing factors of anxiety and depressive symptoms among COVID-19 patients admitted to Fangcang shelter hospitals. From February 23, 2020, to February 26, 2020, we obtained sociodemographic and clinical characteristics information of COVID-19 patients in Jianghan Fangcang Shelter Hospital (Wuhan, China) and assessed their mental health status and sleep quality. Data were obtained with an online questionnaire. The questionnaire consisted of a set of items on demographic characteristics, a set of items on clinical characteristics, the Self-Rating Anxiety Scale, Self-Rating Depression Scale, and Pittsburgh Sleep Quality Index. Three hundred seven COVID-19 patients who were admitted to Jianghan Fangcang Shelter Hospital participated in this study. The prevalence of anxiety and depressive symptoms were 18.6% and 13.4%, respectively. Poor sleep quality and having ≥ two current physical symptoms were independent risk factors for anxiety symptoms. Female sex, having a family member with confirmed COVID-19, and having ≥ two current physical symptoms were independent risk factors for depressive symptoms. Anxiety and depressive symptoms were found to be common among COVID-19 patients in Fangcang Shelter Hospital, with some patients being at high risk.


Assuntos
Ansiedade/epidemiologia , Infecções por Coronavirus/psicologia , Depressão/epidemiologia , Pneumonia Viral/psicologia , Adulto , Betacoronavirus , China/epidemiologia , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Feminino , Hospitais Especializados , Humanos , Masculino , Pessoa de Meia-Idade , Unidades Móveis de Saúde , Pandemias , Pneumonia Viral/epidemiologia , Prevalência , Fatores de Risco
2.
Eur Rev Med Pharmacol Sci ; 24(15): 8202-8209, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32767350

RESUMO

OBJECTIVE: The recent outbreak of SARS-CoV-2 infection in Italy has resulted in a sudden and massive flow of patients into emergency rooms, and a high number of hospitalizations with the need for respiratory isolation. Massive admission of patients to the Policlinico "Agostino Gemelli" Foundation of Rome, Italy, determined the need for reengineering the entire hospital. MATERIALS AND METHODS: In this article, we consider some of the structural and organizational changes that have been necessary to deal with the emergency, with particular reference to non-intensive medicine wards, and the preventive measures aimed at limiting the spread of SARS-CoV-2 infection among hospital staff and patients themselves. RESULTS: 577 staff members were subjected to molecular tests in 1-month period and 3.8% of the total were positive. 636 patients admitted to the COVID-19 pathway were included and analyzed: 45.4% were identified as SARS-CoV-2 positive. More SARS-CoV-2 negative patients were discharged in comparison to SARS-CoV-2 positive patients (59% vs. 41%, respectively). On the other hand, more SARS-CoV-2 positive patients were transferred to ICUs in comparison to SARS-CoV-2 negative patients (16% vs. 1%, respectively). Occurrence of death was similar between the two groups, 11% vs. 7%, for SARS-CoV-2 negative and positive patients, respectively. 25% of ≥80 years old SARS-CoV-2 positive patients died during the hospitalization, while death rate was lower in other age groups (5% in 70-79 years old patients and 0% in remaining age groups). CONCLUSIONS: Rapid hospital reengineering has probably had an impact on the management of patients with and without SARS-CoV-2 infection, and on in-hospital mortality rates over the reporting period.


Assuntos
Infecções por Coronavirus/epidemiologia , Unidades Hospitalares/organização & administração , Controle de Infecções/organização & administração , Admissão e Escalonamento de Pessoal/organização & administração , Pneumonia Viral/epidemiologia , Centros de Atenção Terciária/organização & administração , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Infecções por Coronavirus/terapia , Infecções por Coronavirus/transmissão , Feminino , Pessoal de Saúde/educação , Número de Leitos em Hospital , Hospitais Especializados , Humanos , Controle de Infecções/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Unidades de Terapia Intensiva , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Isolamento de Pacientes , Equipamento de Proteção Individual , Pneumonia Viral/terapia , Pneumonia Viral/transmissão
3.
Respir Res ; 21(1): 169, 2020 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-32620118

RESUMO

BACKGROUND: Since December 2019, the outbreak of COVID-19 caused a large number of hospital admissions in China. Many patients with COVID-19 have symptoms of acute respiratory distress syndrome, even are in danger of death. This is the first study to evaluate dynamic changes of D-Dimer and Neutrophil-Lymphocyte Count Ratio (NLR) as a prognostic utility in patients with COVID-19 for clinical use. METHODS: In a retrospective study, we collected data from 349 hospitalized patients who diagnosed as the infection of the COVID-19 in Wuhan Pulmonary Hospital. We used ROC curves and Cox regression analysis to explore critical value (optimal cut-off point associated with Youden index) and prognostic role of dynamic changes of D-Dimer and NLR. RESULTS: Three hundred forty-nine participants were enrolled in this study and the mortality rate of the patients with laboratory diagnosed COVID-19 was 14.9%. The initial and peak value of D-Dimer and NLR in deceased patients were higher statistically compared with survivors (P < 0.001). There was a more significant upward trend of D-Dimer and NLR during hospitalization in the deceased patients, initial D-Dimer and NLR were lower than the peak tests (MD) -25.23, 95% CI: - 31.81- -18.64, P < 0.001; (MD) -43.73, 95% CI:-59.28- -31.17, P < 0.001. The test showed a stronger correlation between hospitalization days, PCT and peak D-Dimer than initial D-Dimer. The areas under the ROC curves of peak D-Dimer and peak NLR tests were higher than the initial tests (0.94(95%CI: 0.90-0.98) vs. 0.80 (95% CI: 0.73-0.87); 0.93 (95%CI:0.90-0.96) vs. 0.86 (95%CI:0.82-0.91). The critical value of initial D-Dimer, peak D-Dimer, initial NLR and peak NLR was 0.73 mg/L, 3.78 mg/L,7.13 and 14.31 respectively. 35 (10.03%) patients were intubated. In the intubated patients, initial and peak D-Dimer and NLR were much higher than non-intubated patients (P < 0.001). The critical value of initial D-Dimer, peak D-Dimer, initial NLR and peak NLR in prognosticate of intubation was 0.73 mg/L, 12.75 mg/L,7.28 and 27.55. The multivariable Cox regression analysis showed that age (HR 1.04, 95% CI 1.00-1.07, P = 0.01), the peak D-Dimer (HR 1.03, 95% CI 1.01-1.04, P < 0.001) were prognostic factors for COVID-19 patients' death. CONCLUSIONS: To dynamically observe the ratio of D-Dimer and NLR was more valuable during the prognosis of COVID-19. The rising trend in D-Dimer and NLR, or the test results higher than the critical values may indicate a risk of death for participants with COVID-19.


Assuntos
Infecções por Coronavirus/sangue , Infecções por Coronavirus/epidemiologia , Produtos de Degradação da Fibrina e do Fibrinogênio/análise , Contagem de Linfócitos , Neutrófilos , Pneumonia Viral/sangue , Pneumonia Viral/epidemiologia , Adulto , Idoso , Biomarcadores/sangue , Estudos de Coortes , Infecções por Coronavirus/diagnóstico , Feminino , Hospitais Especializados , Humanos , Contagem de Leucócitos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Prognóstico , Modelos de Riscos Proporcionais , Curva ROC , Estudos Retrospectivos , Índice de Gravidade de Doença , Taxa de Sobrevida
4.
Emerg Microbes Infect ; 9(1): 1835-1842, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32726187

RESUMO

Staff and employees "Zero infection" has been achieved during the whole medical activities in the COVID-19 Fangcang Shelter Hospital in Wuhan, China. This study analyses the personnel and environmental protection status of the East-West Lake Fangcang Shelter Hospital. The HCWs were mostly composed of national medical rescue teams, from different provinces in China. Before the COVID-19 outbreak, 82.64% of the HCWs had already known the proper procedure of wearing masks and other personal protective equipment (PPE). For the total of 634 participants entering the inpatient areas, 99.8% of them took occupational protection trainings via various methods. By carefully training and supervision, most of them were competent to work in the inpatient areas six hours/d, three-four times/week. Besides, 7.8% experienced different types of occupational exposure, which mainly caused by the damage of PPE. Once exposed, the HCWs would disinfect skin or mucous in time. No SARS-CoV-2 RNA was detected in 48 air and environmental samples after regular disinfection and cleaning. To conclude, the bundle including intensive training, strengthened personal protection, strict environmental disinfection and timely remedial measures for occupational exposure had ensured the safety of the East-West Lake Fangcang Shelter Hospital.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde/estatística & dados numéricos , Exposição Ocupacional/prevenção & controle , Pandemias/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Adulto , Betacoronavirus/genética , China , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Hospitais Especializados/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Adulto Jovem
5.
J Laryngol Otol ; 134(7): 566-570, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32616080

RESUMO

BACKGROUND: The Nottingham and Nottinghamshire Hospital for Diseases of the Throat, Ear and Nose existed in Nottingham for over 60 years, but there is little knowledge or documentation regarding its existence. METHODS: The following resources were searched to find out more about the hospital: the Nottinghamshire Archives; Manuscripts and Special Collections at the University of Nottingham Libraries; and Nottingham Central Library. Information was also obtained from the founders' relatives. RESULTS: The hospital was founded in 1886, by Dr Donald Stewart, supported by political and clerical leaders. Initially, it treated out-patients only; in-patients were admitted for surgical treatment from 1905. Suitable accommodation was purchased in 1925, on Goldsmith Street, but required much building extension and alteration. Building restrictions during and following World War II prevented expansion. The National Hospital Survey conducted in 1945 considered the clinical work undertaken to be of a minor character, and recommended closure and amalgamation with the services provided by the Nottingham General Hospital. The hospital closed in 1947. CONCLUSION: The specialist hospital was deemed unfit and unsuitable to compete with the comprehensive service provided by the Nottingham General Hospital.


Assuntos
Hospitais Especializados/história , Otolaringologia/história , Inglaterra , História do Século XIX , História do Século XX , Humanos
6.
Indian J Ophthalmol ; 68(8): 1540-1544, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32709770

RESUMO

Purpose: To evaluate the effect of COVID-19 pandemic and national lockdown on patient care at a tertiary-care ophthalmology institute. Methods: Records of all the patients who presented from March 25th to May 3rd, 2020 were scanned to evaluate the details regarding the presenting complaints, diagnosis, advised treatment and surgical interventions. Results: The number of outpatient department visits, retinal laser procedures, intravitreal injections and cataract surgeries during this lockdown decreased by 96.5%, 96.5%, 98.7% and 99.7% respectively compared from the corresponding time last year. Around 38.8% patients could be triaged as non-emergency cases based on history alone while 59.5% patients could be triaged as non-emergency cases after examination. Only eighty-four patients opted for video-consultation from April 15th to May 3rd, 2020. Nine patients presented with perforated corneal ulcer, but could not undergo penetrating keratoplasty due to the lack to available donor corneal tissue. One of these patients had to undergo evisceration due to disease progression. Two patients with open globe injury presented late after trauma and had to undergo enucleation. Around 9% patients could not undergo the advised urgent procedure due to logistical issues related to the lockdown. Conclusion: A significant number of patients could not get adequate treatment during the lockdown period. Hospitals need to build capacity to cater to the expected patient surge post-COVID-19-era, especially those requiring immediate in-person attention. A large number of patients can be classified as non-emergency cases. These patients need to be encouraged to follow-up via video-consultation to carve adequate in-person time for the high-risk patients.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Oftalmopatias/terapia , Oftalmologia/estatística & dados numéricos , Pandemias , Assistência ao Paciente/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Quarentena , Academias e Institutos/organização & administração , Academias e Institutos/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Serviços Médicos de Emergência/estatística & dados numéricos , Feminino , Hospitais Especializados/organização & administração , Hospitais Especializados/estatística & dados numéricos , Humanos , Índia/epidemiologia , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Oftalmologia/organização & administração , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricos
7.
Indian J Ophthalmol ; 68(8): 1546-1550, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32709772

RESUMO

Purpose: To find the clinical profile and prevalence of conjunctivitis and other ocular manifestations in mild COVID-19 positive patients in a nodal COVID-19 hospital. Methods: A retrospective cross-sectional, single-center study conducted in 127 mild cases of COVID-19 positive patients admitted between 27th March and 19th April 2020 in a tertiary care COVID-19 hospital in north India. From the hospital records, demographic data is collected. Ocular history and ocular examinations were done by face-to-face survey during ward rounds. Results: A total of 127 patients were included in the study with a median age of 38.8 years. Forty-eight (37.80%) patients had upper respiratory tract symptoms, 20 (15.75%) patients had systemic illness, 18 (14.17%) patients were using spectacles, and 50 (39.37%) patients had history of hand-eye contact. Out of 12 (9.45%) patients who had ocular complaints, 11 (8.66%) had ocular manifestation after admission. Among 11 patients, eight (6.29%) had conjunctival congestion. Three (3/8) patients had developed conjunctival congestion even before the manifestation of definite COVID-19 symptoms. Five patients (5/8) patients had no other associated ocular symptoms other than congestion. Six patients (6/8) had symptoms of upper respiratory tract infection. Conclusion: Mild conjunctivitis manifesting as conjunctival congestion is common and is one of the major ocular manifestations in COVID-19 positive patients even with milder disease.


Assuntos
Betacoronavirus , Conjuntivite Viral/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções Oculares Virais/epidemiologia , Hospitais Especializados/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Conjuntivite Viral/diagnóstico , Infecções por Coronavirus/diagnóstico , Estudos Transversais , Infecções Oculares Virais/diagnóstico , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/diagnóstico , Prevalência , Estudos Retrospectivos , Atenção Terciária à Saúde/estatística & dados numéricos
9.
Cir. Esp. (Ed. impr.) ; 98(6): 320-327, jun.-jul. 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-187154

RESUMO

INTRODUCCIÓN: La rápida expansión de la infección por SARS-CoV-2 ha supuesto una radical reorganización de los recursos sanitarios y la exposición de profesionales al contagio. Los servicios de Cirugía General y del Aparato Digestivo también necesitan adaptarse a este cambio. PACIENTES Y MÉTODOS: Se realiza un estudio observacional descriptivo prospectivo de los casos de COVID-19 en pacientes y cirujanos de un Servicio de Cirugía General en un área de alta incidencia de infección entre el 1 y el 31 de marzo de 2020. RESULTADOS: Pacientes: La incidencia de infección por SARS-CoV-2 en los pacientes programados con hospitalización en el postoperatorio inmediato fue del 7%. Su edad media fue de 59,5 años y todos evolucionaron satisfactoriamente en planta. De 36 pacientes intervenidos de urgencia, dos fueron SARS-CoV-2+ y uno altamente sospechoso de COVID-19 (11,1%). Los tres pacientes fallecieron por insuficiencia respiratoria, su edad media era de 81 años. Cirujanos: Hubo un total de 12 casos SARS-CoV-2 + confirmados (24,4%) (8 de 34 adjuntos y 4 de 15 residentes).Actividad asistencial: El número medio de intervenciones quirúrgicas urgentes diarias bajó de 3,6 en febrero a 1,16 en el mes de marzo. El 42% de los pacientes intervenidos a partir de la entrada en vigor de las primeras medidas de aislamiento a nivel regional, presentaban cuadros evolucionados. CONCLUSIONES: El aumento de casos en la población general de COVID-19 debe alertar a los Servicios de Cirugía General de la necesidad de tomar de medidas de forma precoz que garanticen la seguridad de los pacientes y de los cirujanos


INTRODUCTION: The rapid spread of SARS-CoV-2 infection has led to a radical reorganization of healthcare resources. Surgical Departments need to adapt to this change. PATIENTS AND METHODS:We performed a prospective descriptive observational study of the incidence of COVID-19 in patients and surgeons of a General Surgical Department in a high prevalence area, between the 1st and 31st of March 2020. RESULTS:Patients: The incidence of SARS-CoV-2 infection in elective surgery patients was 7% (mean age 59.5 years). All survived.Of 36 patients who underwent emergency surgery, two of them were SARS-CoV-2 positive and one was clinically highly suspicious of COVID-19 (11.1%). All three patients died of respiratory failure (mean age 81 years). Surgeons: There were a total of 12 confirmed SARS-CoV-2+ cases among the surgical department staff (24.4%) (8 out of 34 consultants and 4 out of 15 residents).Healthcare activity: The average number of daily emergency surgical interventions declined from 3.6 in February to 1.16 in March. 42% of the patients who underwent emergency surgery had peritonitis upon presentation. CONCLUSIONS: The fast pace of COVID-19 pandemia, should alert surgical departments of the need of adopting early measures to ensure the safety of patients and staff


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Centro Cirúrgico Hospitalar/estatística & dados numéricos , Betacoronavirus/genética , Doenças Profissionais/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Serviços Médicos de Emergência , Cuidados Pré-Operatórios , Estudos Prospectivos , Incidência , Espanha/epidemiologia , Tomografia Computadorizada por Raios X , Reação em Cadeia da Polimerase em Tempo Real , Hospitais Especializados
10.
Ann Agric Environ Med ; 27(2): 201-206, 2020 Jun 19.
Artigo em Inglês | MEDLINE | ID: mdl-32588593

RESUMO

INTRODUCTION: The article describes the process of converting a large multi-specialized hospital into one dedicated to COVID-19 patients, and present established standards of work organization in all the wards and training system of the medical and supporting staff. The several weeks pandemic of the COVID-19 disease has forced the healthcare systems of numerous countries to adjust their resources to the care of the growing number of COVID-19 patients. Managers were presented with the challenge of protecting the healthcare workers from transmission of the disease within medical institutions, and issues concerning the physical and psychological depletion of personnel. MATERIAL AND METHODS: Based on analyses of the structure and work processes in Central Clinical Hospital (CCH) reconstructive strategic plan was developed. It included: division of existing wards into observation and isolation wards; installing locks; weekly plan for supplying personal protection equipment (PPE); designating new access to the hospital and communication routes; training of medical and supporting staff. The plan was implemented from the first days of conversion of the hospital. RESULTS: The wards of the CCH were converted for observation and isolation, and each one was fitted with sanitary locks. There was a big improvement in the supply of PPE for the medical staff. Separation of the 'dirty' and 'clean' parts of the CCH were attained, and widespread intensive training not only protected personnel against infections, but also diminished unrest which was discernable at the beginning of conversion. CONCLUSIONS: The transformation efforts will ultimately be appraised at the end of the epidemic, but the data looks encouraging. Two weeks after conversion, the testing of hospital Staff was started and by the end of April, 459 tests were had been conducted, of which only 11 were positive.


Assuntos
Betacoronavirus , Infecções por Coronavirus/terapia , Administração Hospitalar , Hospitais Especializados/organização & administração , Controle de Infecções/métodos , Pneumonia Viral/terapia , Pessoal de Saúde , Humanos , Pandemias , Equipamento de Proteção Individual , Polônia
11.
Infez Med ; 28(suppl 1): 84-88, 2020 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-32532943

RESUMO

Clinical presentation of COVID-19 is common to other respiratory infections. We compared the characteristics at hospital admission of confirmed and not-confirmed COVID-19 patients, in the early phase of the epidemic. Thirty-seven suspected patients were enrolled, and COVID-19 was confirmed in 17. Confirmed patients are older, have more frequently contact with confirmed cases. Distinctive clinical characteristics among COVID-19 were the grand-glass opacities at CT scan, and a pO2/FiO2 ratio less than 250. In not-confirmed group, Influenza represented the most frequent alternative diagnosis. This study contributes to highlight the characteristics to consider at hospital admission in order to promptly suspect COVID-19.


Assuntos
Técnicas de Laboratório Clínico , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Adulto , Estudos de Coortes , Busca de Comunicante , Infecções por Coronavirus/diagnóstico , Diagnóstico Diferencial , Reações Falso-Positivas , Feminino , Hospitais Especializados/estatística & dados numéricos , Humanos , Infectologia , Itália , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia/diagnóstico , Pneumonia/epidemiologia , Pneumonia Viral/diagnóstico , Fatores de Risco , Centros de Cuidados de Saúde Secundários/estatística & dados numéricos , Superinfecção , Avaliação de Sintomas
13.
Stroke ; 51(7): 2224-2227, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32516064

RESUMO

BACKGROUND AND PURPOSE: This study aims to assess the number of patients with acute ischemic cerebrovascular events seeking in-patient medical emergency care since the implementation of social distancing measures in the coronavirus disease 2019 (COVID-19) pandemic. METHODS: In this retrospective multicenter study, data on the number of hospital admissions due to acute ischemic stroke or transient ischemic attack and numbers of reperfusion therapies performed in weeks 1 to 15 of 2020 and 2019 were collected in 4 German academic stroke centers. Poisson regression was used to test for a change in admission rates before and after the implementation of extensive social distancing measures in week 12 of 2020. The analysis of anonymized regional mobility data allowed for correlations between changes in public mobility as measured by the number and length of trips taken and hospital admission for stroke/transient ischemic attack. RESULTS: Only little variation of admission rates was observed before and after week 11 in 2019 and between the weeks 1 and 11 of 2019 and 2020. However, reflecting the impact of the COVID-19 pandemic, a significant decrease in the number of admissions for transient ischemic attack was observed (-85%, -46%, -42%) in 3 of 4 centers, while in 2 of 4 centers, stroke admission rates decreased significantly by 40% and 46% after week 12 in 2020. A relevant effect on reperfusion therapies was found for 1 center only (thrombolysis, -60%; thrombectomy, -61%). Positive correlations between number of ischemic events and mobility measures in the corresponding cities were identified for 3 of 4 centers. CONCLUSIONS: These data demonstrate and quantify decreasing hospital admissions due to ischemic cerebrovascular events and suggest that this may be a consequence of social distancing measures, in particular because hospital resources for acute stroke care were not limited during this period. Hence, raising public awareness is necessary to avoid serious healthcare and economic consequences of undiagnosed and untreated strokes and transient ischemic attacks.


Assuntos
Betacoronavirus , Isquemia Encefálica/epidemiologia , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Doença Aguda , Idoso , Isquemia Encefálica/terapia , Área Programática de Saúde , Feminino , Alemanha/epidemiologia , Hospitais Especializados/estatística & dados numéricos , Humanos , Ataque Isquêmico Transitório/epidemiologia , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Utilização de Procedimentos e Técnicas , Reperfusão/estatística & dados numéricos , Estudos Retrospectivos , Acidente Vascular Cerebral/terapia
14.
Inflamm Bowel Dis ; 26(8): 1144-1148, 2020 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-32476001

RESUMO

BACKGROUND: After the first case of infection with the novel coronavirus, SARS-CoV-2, in China, an outbreak rapidly spread, finally evolving into a global pandemic. The new disease was named coronavirus disease 2019 (COVID-19) and by May 10, 2020, it has affected more than 4 million people worldwide and caused more than 270,000 deaths. METHODS: We describe the Greek experience regarding the response to COVID-19, with particular focus on 2 COVID-19 reference hospitals in the metropolitan area of Athens, the capital of Greece. RESULTS: The first case of SARS-CoV-2 infection in Greece was reported on February 26, 2020, and prompted a decisive response from the Greek government. The primary focus was containment of virus spread, considering shortage of ICU beds. A general lockdown was implemented early on, and the national Health Care System underwent massive re-structuring. Our 2 gastrointestinal (GI) centers, which provide care for more than 1500 inflammatory bowel disease (IBD) patients, are located in hospitals that were transformed to COVID-19 reference centers. To maintain sufficient care for our patients, while also contributing to the fight against COVID-19, we undertook specific measures. These included provision of telemedicine services, electronic prescriptions and home delivery of medications, isolation of infusion units and IBD clinics in COVID-free zones of the hospitals, in addition to limiting endoscopies to emergencies only. Such practices allowed us to avoid interruption of appropriate therapies for IBD patients. In fact, within the SECURE-IBD database, there have been only 4 Greek IBD patients, to date, who have been reported as positive for SARS-CoV-2. CONCLUSION: Timely application of preventive measures and strict compliance to guidelines limited the spread of COVID-19 in Greece and minimally impacted our IBD community, without interfering with therapeutic management.


Assuntos
Controle de Doenças Transmissíveis/organização & administração , Doenças Transmissíveis Emergentes/prevenção & controle , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/organização & administração , Avaliação de Resultados em Cuidados de Saúde , Pneumonia Viral/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Adulto , Defesa Civil , Infecções por Coronavirus/prevenção & controle , Feminino , Grécia , Hospitais Especializados/organização & administração , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/terapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Medição de Risco , Síndrome Respiratória Aguda Grave/prevenção & controle , População Urbana
15.
Recurso na Internet em Espanhol | LIS - Localizador de Informação em Saúde | ID: lis-47423

RESUMO

Contribuimos a garantizar el derecho a la salud de la población a través de acciones de promoción, prevención, recuperación y rehabilitación en pacientes adultos, con énfasis en rehabilitación y cuidados paliativos, y nos especializamos en líneas de cuidado de la Enfermedad de Hansen —lepra—


Assuntos
Hanseníase , Hospitais Federais , Hospitais Especializados , Hospitais de Dermatologia Sanitária de Patologia Tropical
16.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47400

RESUMO

O Instituto Lauro de Souza Lima foi criado em 1933 como Asilo-Colônia Aymores onde eram internados os portadores de hanseníase do estado de São Paulo e região. A partir de 1989, com o decreto nº 30.521 de 02/10/89 o hospital transforma-se num Instituto de Pesquisa, da Secretaria da Saúde do Estado de São Paulo passando a ser denominadoInstituto lauro de Souza Lima. Hoje é centro de referência na área de Dermatologia Geral e , em particular , da Hanseníase para a Secretaria de Saúde do Estado de São Paulo, Ministério da Saúde e da Organização Mundial da Saúde - OMS. Além dos serviços na área de dermatologia, o Instituto Lauro de Souza Lima também realiza atividades voltadas à pesquisa, ensino, reabilitação física, terapia ocupacional, fisioterapia e cirurgias plásticas corretivas.


Assuntos
Hanseníase , Hospitais Especializados , Hospitais Estaduais , Hospitais de Dermatologia Sanitária de Patologia Tropical
17.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-47401

RESUMO

A Fundação de Dermatologia Tropical e Venereologia Alfredo da Matta (FUAM), órgão da Administração Indireta do Poder Executivo do Amazonas, vinculada à Secretaria de Estado de Saúde (Susam) é um Centro de Referência estadual, nacional e internacional nas áreas de Hanseníase, Dermatologia Tropical e Infecções Sexualmente Transmissíveis (IST). Tem como finalidade realizar ações de prevenção e atendimento ambulatorial a pacientes de Hanseníase e à população em geral que busca assistência em dermatologia clínica, IST/HIV/Aids e cirurgias dermatológicas, com atendimento a pacientes com câncer de pele. Atua ainda nas áreas de ensino e pesquisa, com cursos e treinamentos, estágios, com o Programa de Residência Médica em Dermatologia, além do Curso de Mestrado Profissional em Ciências Aplicadas à Dermatologia (UEA/Fuam). Coordenadora das ações do controle de Hanseníase no Estado do Amazonas.


Assuntos
Hanseníase , Hospitais de Dermatologia Sanitária de Patologia Tropical , Hospitais Especializados , Hospitais Estaduais
20.
BMJ Open Qual ; 9(2)2020 05.
Artigo em Inglês | MEDLINE | ID: covidwho-355840

RESUMO

BACKGROUND: The COVID-19 outbreak has placed the National Health Service under significant strain. Social distancing measures were introduced in the UK in March 2020 and virtual consultations (via telephone or video call) were identified as a potential alternative to face-to-face consultations at this time. LOCAL PROBLEM: The Royal National Orthopaedic Hospital (RNOH) sees on average 11 200 face-to-face consultations a month. On average 7% of these are delivered virtually via telephone. In response to the COVID-19 crisis, the RNOH set a target of reducing face-to-face consultations to 20% of all outpatient attendances. This report outlines a quality improvement initiative to rapidly implement virtual consultations at the RNOH. METHODS: The COVID-19 Action Team, a multidisciplinary group of healthcare professionals, was assembled to support the implementation of virtual clinics. The Institute for Healthcare Improvement approach to quality improvement was followed using the Plan-Do-Study-Act (PDSA) cycle. A process of enablement, process redesign, delivery support and evaluation were carried out, underpinned by Improvement principles. RESULTS: Following the target of 80% virtual consultations being set, 87% of consultations were delivered virtually during the first 6 weeks. Satisfaction scores were high for virtual consultations (90/100 for patients and 78/100 for clinicians); however, outside of the COVID-19 pandemic, video consultations would be preferred less than 50% of the time. Information to support the future redesign of outpatient services was collected. CONCLUSIONS: This report demonstrates that virtual consultations can be rapidly implemented in response to COVID-19 and that they are largely acceptable. Further initiatives are required to support clinically appropriate and acceptable virtual consultations beyond COVID-19. REGISTRATION: This project was submitted to the RNOH's Project Evaluation Panel and was classified as a service evaluation on 12 March 2020 (ref: SE20.09).


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Telemedicina/organização & administração , Hospitais Especializados , Humanos , Ortopedia , Pandemias , Melhoria de Qualidade , Medicina Estatal , Reino Unido/epidemiologia
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