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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-48255

RESUMO

O Ministério da Saúde habilitou o Hospital Universitário (HU-UFJF/Ebserh) a ter um serviço de referência no atendimento a doenças raras. Os pacientes do Sistema Único de Saúde (SUS) poderão contar com diagnóstico clínico e molecular; aconselhamento genético; exames laboratoriais e de imagem; tratamentos específicos (quando disponíveis); reabilitação e orientações aos usuários, familiares e cuidadores quanto a doenças específicas. O Serviço Especializado em Doenças Raras pretende proporcionar atendimento multidisciplinar ao usuário, buscando a excelência na assistência global da pessoa com doença rara. Além disso, contribuirá na formação e no treinamento de profissionais da atenção primária no atendimento, reconhecimento e encaminhamento desses pacientes.


Assuntos
Hospitais Universitários , Doenças Raras/diagnóstico , Doenças Raras/prevenção & controle , Sistema Único de Saúde
2.
Pan Afr Med J ; 38: 253, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34104301

RESUMO

Introduction: proper tuberculosis (TB) infection control (TBIC) practice of health professionals is one of the effective TB prevention approaches. Despite this reality, the TBIC practice of health care workers was not been well studied. This study assessed the TBIC practice of health professionals and associated factors in Mizan Tepi University Teaching Hospital, southwest Ethiopia. Methods: an institution based quantitative cross-sectional study was conducted from September 1 to 30, 2019, by including all health professionals in the hospital. Participants who answered at least 50% of TBIC practice questions correctly were categorized as having good TBIC practice. Binary logistic regression was used to identify factors associated with the practice of the participants. The odds ratio with a 95% confidence interval and p-value was used to measure the strength of association; the significant association was declared at a p-value less than 0.05. Results: the study found that 64.1% (95% CI: 56.6%, 70.7%) of the participants had good TBIC practice. More than half, 102(51.5 %) of study participants have service years of greater than or equal to five years. Only the service year of health professionals was significantly associated [95%CI (AOR= 2.43; 95%CI: 1.28, 4.6)] with the respondents´ TBIC practice. Conclusion: only less than two-third of health professionals had good TBIC practice which is inadequate. And also experienced staff had significantly better TBIC practice. As a result, health professionals in MTUTH should be supported to practice TBIC as routine activity and opportunities should be made for senior staffs to share their TBIC experiences with others.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Controle de Infecções/métodos , Tuberculose/prevenção & controle , Adulto , Estudos Transversais , Etiópia , Feminino , Hospitais Universitários , Humanos , Masculino , Inquéritos e Questionários , Fatores de Tempo
3.
BMC Infect Dis ; 21(1): 535, 2021 Jun 07.
Artigo em Inglês | MEDLINE | ID: mdl-34098882

RESUMO

BACKGROUND: During the SARS-CoV-2 pandemic a mass casualty incident of ambulatory patients occurred at the COVID-19 rapid response infrastructure (CRRI) facility at the University Hospital of Cologne (UHC). We report the development of a patient-centred mobile-device solution to support efficient management of the facility, triage of patients and rapid delivery of test results. METHODS: The UHC-Corona Web Tool (CWT) was developed as a web-based software useable on each patient's smartphone. It provides, among others, a self-reported medical history including type and duration of symptoms and potential risk contacts and links all retrieved information to the digital patient chart via a QR code. It provides scheduling of outpatient appointments and automated transmission of SARS-CoV-2 test results. RESULTS: The UHC-CWT was launched on 9 April 2020. It was used by 28,652 patients until 31 August 2020. Of those, 15,245 (53,2%) consulted the CRRI, representing 43,1% of all CRRI patients during the observed period. There were 8304 (29,0%) specifications concerning travel history and 17,145 (59,8%) indications of ≥1 symptom of SARS-CoV-2 infection. The most frequently indicated symptoms were sore throat (60,0%), headache (50,7%), common cold (45,1%) and cough (42,6%) while 11,057 (40,2%) patients did not report any symptoms. After implementation of the UHC-CWT, the amount of patient contacts per physician rose from 38 to 98,7 per day. The personnel for communication of test results were reduced from four on seven days to one on five days. CONCLUSION: The UHC-CWT is an effective digital solution for management of large numbers of outpatients for SARS-CoV-2 testing.


Assuntos
Teste para COVID-19/métodos , COVID-19/diagnóstico , Internet , Triagem/métodos , Instituições de Assistência Ambulatorial , Registros Eletrônicos de Saúde , Alemanha , Hospitais Universitários , Humanos , Masculino , Anamnese , Pandemias , Smartphone , Inquéritos e Questionários , Viagem
4.
Rev Med Liege ; 76(5-6): 300-306, 2021 May.
Artigo em Francês | MEDLINE | ID: mdl-34080355

RESUMO

The Arsène Burny Cancer Institute (ICAB) of the CHU de Liège is the reference university medical center, open to its environment, dedicated to cancer care. Transversality, academic expertise, quality of care and direct links with research are at the heart of this ambitious achievement, which is much more than a building. The Integrated Center of Oncology (CIO) is the new ICAB building, dedicated to outpatient cancer care and high performance technical platforms such as radiotherapy with its Cyberknife, oncology imaging with its radiopharmacy, the Laboratory of Cell and Gene Therapy, the Liège University Hospital Biobank, or the laboratories grouped together within Unilab, while hospitalizations remain in the existing towers of the CHU.


Assuntos
Neoplasias , Diagnóstico por Imagem , Hospitais Universitários , Humanos
5.
Stud Health Technol Inform ; 282: 273-287, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34085975

RESUMO

Public hospitals should be designed to clover as wider inclusivity levels as possible forproviding access for all. Unfortunately, and for a variety of reasons, a quality service is not always provided. When evaluation of the service quality in healthcare organizations is carried out, it is mostly conducted in terms of medical service quality, whilst the physical layout, functionality and facilitating devices are not given as much scrutiny. Post Occupation Evaluation (POE) is notably an efficient process for checking the satisfaction of users after the building has been in-used for a certain period of times. However, hospital is generally a type of building and service that need to support users with a variety of physical capabilities thus, a conventional POE may not cover all requirements of users, so this research has employed the UD concepts as a basis to combined with POE for evaluating service performance of a hospital of the case study, Naresuan University hospital, THAILAND. Even though the POE delivered a good design suggestion that is beneficial to users with a wide range of physical ability but that may not guarantee the new design will be agreed by all stakeholders and implemented through success. As a matter of fact, to success an implementing of a good design does not depend solely on a designer, specifically for this case study, a universal design to a hospital. This research found that to make UD perfectly effects in a hospital (in Thailand context) may require more supportive factors beyond just pointing out problems related to physical conditions of the design and suggest a design solution. As in the context of Thailand, this research identified 4 factors contributing to the success of UD which the designer should be accountable for (1) public understanding of the basic concepts of UD (2) all the related background such as culture, tradition and economic etc. that contributed the attitudes of all stakeholders (of the hospital) towards people with physical impairments (3) the rights, laws, regulations and policies for people with disabilities in the context of the country and (4) the participation of all types of users. And in doing so, this research added an extensive evaluation to the general POE to cover as more factors as possible to those involved with the design implementation. Therefore, an extensive evaluation process so called "Comprehensive Post-Occupancy Evaluation C-POE" has been created and employed in this study for offering more comprehensive solution that cover all possibilities cause of problems, the evaluation processes are as follows; (1) evaluating physical features and users' behavior (the experimental access audit), (2) examining administrative policy, HA and UD principles and (3) interviewing attitude of executives about UD.


Assuntos
Políticas , Design Universal , Atitude , Hospitais Universitários , Humanos , Tailândia
6.
Artigo em Inglês | MEDLINE | ID: mdl-34064610

RESUMO

Safety of healthcare workers in hospitals is a major concern during the COVID-19 pandemic. Being exposed for several working hours per day to infected patients, nurses dealing with COVID-19 face several issues that lead to physical/psychological breakdown. This study focused on burnout and its associated factors in nurses working in an Italian University Hospital during the first wave of COVID-19 pandemic. We designed a web-based cross-sectional study addressed to nurses working at the University Hospital in Foggia, Italy. The online questionnaire was organized in sections aimed at collecting demographic and occupational variables, including the Maslach Burnout Inventory (MBI) and the Oldenburg Burnout Inventory (OBI). Two hundred and ninety-three nurses agreed to participate. According to MBI, we reported moderate/high emotional exhaustion in 76.5%, depersonalization in 50.2%, and personal gratification in 54.6% of participants. COVID-19-related burnout measured by OBI resulted medium/high in 89.1% of participants. Among demographic and occupational factors, a multivariate regression analysis identified emotional support, consideration of leaving job, and workload as predictive of burnout in nurses. In conclusion, this study suggests that the improvement of employer and family support to nurses, as well as reduction of workload and job-related stress, would contribute to reducing burnout in nurses during COVID-19 pandemics.


Assuntos
Esgotamento Profissional , Enfermeiras e Enfermeiros , Esgotamento Profissional/epidemiologia , Esgotamento Psicológico , Estudos Transversais , Hospitais Universitários , Humanos , Itália/epidemiologia , Pandemias , Inquéritos e Questionários
7.
Artigo em Inglês | MEDLINE | ID: mdl-34069955

RESUMO

BACKGROUND: burnout syndrome is a serious and growing problem among medical staff. Its adverse outcomes not only affect health-care providers' health, but also extend to their patients, resulting in bad-quality care. The COVID-19 pandemic puts frontline health-care providers at greater risk of psychological stress and burnout syndrome. OBJECTIVES: this study aimed to identify the levels of burnout among health-care professionals currently working at Assiut University hospitals during the COVID-19 pandemic. METHODS: the current study adopted an online cross-sectional design using the SurveyMonkey® website for data collection. A total of 201 physicians were included and the Maslach Burnout Inventory (MBI) scale was used to assess the three burnout syndrome dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. RESULTS: about one-third, two-thirds, and one-quarter of the respondents had high emotional exhaustion, high depersonalization, and low personal accomplishment, respectively. Younger, resident, and single physicians reported higher burnout scores. The personal accomplishment score was significantly higher among males. Those working more than eight hours/day and dealing with COVID-19 patients had significantly higher scores. CONCLUSION: during the COVID-19 pandemic, a high prevalence of burnout was recorded among physicians. Age, job title, working duration, and working hours/day were significant predictors for burnout syndrome subscale results. Preventive and interventive programs should be applied in health-care organizations during pandemics.


Assuntos
Esgotamento Profissional , Esgotamento Profissional/epidemiologia , Esgotamento Psicológico/epidemiologia , Estudos Transversais , Hospitais Universitários , Humanos , Masculino , Pandemias , Inquéritos e Questionários
8.
Nefrología (Madrid) ; 41(3): 329-336, mayo.-jun. 2021. tab
Artigo em Espanhol | IBECS | ID: ibc-196539

RESUMO

INTRODUCCIÓN: La enfermedad por coronavirus 2019 (COVID-19) es una infección viral causada por un nuevo coronavirus que está afectando a todo el mundo. Hay estudios previos de pacientes en hemodiálisis en centro, pero hay pocos datos sobre población en diálisis domiciliaria. Nuestro objetivo es estudiar la incidencia y evolución de la COVID-19 en una unidad de diálisis domiciliaria (UDD) durante el pico de la pandemia. MÉTODOS: Estudio observacional y retrospectivo que incluye todos los pacientes diagnosticados de COVID-19 de la UDD del Hospital Universitario La Paz (Madrid, España) entre el 10 de marzo y el 15 de mayo de 2020. Se recogieron los datos clínicos de la UDD (57 pacientes en diálisis peritoneal y 22 pacientes en hemodiálisis domiciliaria) y comparamos las características clínicas y la evolución de los pacientes con o sin infección por COVID-19. RESULTADOS: Doce pacientes fueron diagnosticados de COVID-19 (9 diálisis peritoneal, 3 hemodiálisis domiciliaria). No hubo diferencias estadísticamente significativas entre las características clínicas de los pacientes con COVID-19 y el resto de la unidad. La edad media fue 62 ± 18,5 años; la mayoría eran varones (75%). Todos los pacientes menos uno necesitaron hospitalización. Diez pacientes (83%) fueron dados de alta tras una media de 16,4 ± 9,7 días de hospitalización. Dos pacientes fueron diagnosticados durante su hospitalización por otro motivo y fueron los únicos que fallecieron. Los fallecidos eran de mayor edad que los supervivientes. CONCLUSIÓN: La incidencia de COVID-19 en nuestra UDD en Madrid durante el pico de la pandemia fue alto, especialmente en los pacientes en diálisis peritoneal, sin observarse un potencial beneficio para prevenir la infección en los pacientes en diálisis domiciliaria. La edad avanzada y la transmisión nosocomial fueron los principales factores relacionados con peor pronóstico


INTRODUCTION: The 2019 coronavirus (COVID-19) is a viral infection caused by a new coronavirus that is affecting the entire world. There have been studies of patients on in-center hemodialysis, but home dialysis population data are scarce. Our objective is to study the incidence and course of COVID-19 in a home dialysis unit (HDU) at the height of the pandemic. METHODS: An observational, retrospective study enrolling all patients diagnosed with COVID-19 from the HDU of Hospital Universitario La Paz (La Paz University Hospital) (Madrid, Spain) between March 10 and May 15, 2020. We collected clinical data from the HDU (57 patients on peritoneal dialysis and 22 patients on home hemodialysis) and compared the clinical characteristics and course of patients with and without COVID-19 infection. RESULTS: Twelve patients were diagnosed with COVID-19 (9 peritoneal dialysis; 3 home hemodialysis). There were no statistically significant differences in terms of clinical characteristics between patients with COVID-19 and the rest of the unit. The mean age was 62 ± 18.5 years; most were men (75%). All patients but one required hospitalization. Ten patients (83%) were discharged following a mean of 16.4 ± 9.7 days of hospitalization. Two patients were diagnosed while hospitalized for other conditions, and these were the only patients who died. Those who died were older than those who survived. CONCLUSION: The incidence of COVID-19 in our HDU in Madrid at the height of the pandemic was high, especially in patients on peritoneal dialysis. No potential benefit for preventing the infection in patients on home dialysis was observed. Advanced age and nosocomial transmission were the main factors linked to a worse prognosis


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Infecções por Coronavirus/epidemiologia , Hemodiálise no Domicílio/estatística & dados numéricos , Estudos Retrospectivos , Pandemias , Incidência , Hospitais Universitários/estatística & dados numéricos , Estatísticas não Paramétricas , Fatores de Tempo , Diálise Peritoneal/estatística & dados numéricos , Espanha/epidemiologia
9.
Medicine (Baltimore) ; 100(21): e26033, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34032724

RESUMO

ABSTRACT: Infections with hepatitis C virus (HCV) represent a substantial national and international public health burden. HCV has been associated with numerous extrahepatic conditions and can lead to metabolic derangements that are associated with atherosclerosis and cardiovascular disease. We investigated whether HCV infection is associated with an increased number of acute coronary syndrome (ACS) events among hospitalized patients in an inner-city tertiary hospital.We performed a matched (age, sex, and race/ethnicity) case-control study on patients at least 18 years old admitted to inpatient medical and cardiac services at the University of Maryland Medical Center from 2015 through 2018. The primary outcome was ACS and the primary exposure was HCV infection. Covariates of interest included: alcohol use, tobacco use, illicit drug use, hypertension, diabetes mellitus, human immunodeficiency virus infection, body mass index, dyslipidemia, and family history of coronary heart disease. Covariates with significant associations with both exposure and outcome in bivariate analyses were included in the multivariable analyses of the final adjusted model.There were 1555 cases and 3110 controls included in the final sample. Almost 2% of cases and 2.4% of controls were HCV infected. In adjusted models, there was no significant association found between experiencing an ACS event in those with HCV infection compared to those without HCV infection (odds ratio 0.71, 95% confidence interval 0.45-1.11).We found no significant association between HCV infection and ACS in our study population. However, given the mixed existing literature, the association between HCV and ACS warrants further investigation in future prospective cohort and/or interventional studies.


Assuntos
Síndrome Coronariana Aguda/epidemiologia , Hepatite C/epidemiologia , Síndrome Coronariana Aguda/etiologia , Síndrome Coronariana Aguda/metabolismo , Síndrome Coronariana Aguda/terapia , Idoso , Estudos de Casos e Controles , Feminino , Hepatite C/complicações , Hepatite C/metabolismo , Hospitais Universitários/estatística & dados numéricos , Humanos , Masculino , Maryland/epidemiologia , Pessoa de Meia-Idade , Admissão do Paciente/estatística & dados numéricos , Fatores de Risco , Centros de Atenção Terciária/estatística & dados numéricos
10.
Online braz. j. nurs. (Online) ; 20: e20216487, 05 maio 2021. tab
Artigo em Inglês, Espanhol, Português | LILACS, BDENF - Enfermagem | ID: biblio-1224139

RESUMO

OBJETIVO: Avaliar os efeitos da musicoterapia nas respostas fisiológicas do recém-nascido pré-termo (RNPT) em ventilação não invasiva. MÉTODO: Estudo quase-experimental, de grupo único, do tipo antes e depois, com trinta prematuros, hospitalizados em uma Unidade de Terapia Intensiva Neonatal. RESULTADOS: Em relação à frequência respiratória (FR), observou-se redução de até seis incursões por minuto (p=<0,001) e em relação à frequência cardíaca (FC), de até sete batimentos por minuto (p=<0,002). Na saturação de oxigênio, identificou-se o aumento em média de 2% (p=0,003). A temperatura axilar apresentou aumento de 0,1ºC após a intervenção (p=0,05). Na escala de dor, identificou-se uma redução de um ponto (p=0,001). DISCUSSÃO: A musicoterapia apresenta efeitos benéficos em relação a redução da FR, da FC e do nível de dor, bem como, aumento da saturação de oxigênio e da temperatura axilar. CONCLUSÃO: A musicoterapia interfere positivamente nas respostas fisiológicas do RNPT em ventilação não invasiva.


OBJECTIVE: To evaluate the effects of music therapy on the physiological responses of preterm newborns (PTNBs) on non-invasive ventilation. METHOD: A quasi-experimental study, with a single group and of the before-and-after type, conducted with thirty premature infants in a Neonatal Intensive Care Unit. RESULTS: As for respiratory frequency (RF), a reduction of up to six breaths per minute was observed (p=<0.001) and, in relation to heart rate (HR), the reduction was up to seven beats per minute (p=<0.002). In oxygen saturation, a 2% (p=0.003) mean increase was identified. Axillary temperature presented a 0.1ºC increase after the intervention (p=0.05). In the pain scale, a one-point reduction (p=0.001) was identified. DISCUSSION: Music therapy presents beneficial effects in relation to reductions in RF, HR and pain level, as well as an increase in oxygen saturation and axillary temperature. CONCLUSION: Music therapy interferes positively with the physiological responses of PTNBs on non-invasive ventilation.


OBJETIVO: Evaluar los efectos de la musicoterapia sobre las respuestas fisiológicas de los recién nacidos prematuros (RNP) con ventilación no invasiva. MÉTODO: Estudio cuasiexperimental, de un solo grupo, del tipo antes y después, con treinta prematuros, hospitalizados en una Unidad de Terapia Intensiva Neonatal. RESULTADOS: Se observó una reducción de la frecuencia respiratoria (FR) de hasta seis respiraciones por minuto (p=<0,001) y de la frecuencia cardíaca (FC) de hasta siete latidos por minuto (p=<0,002). Se detectó un aumento del 2% (p=0,003) en la saturación de oxígeno. La temperatura axilar aumentó 0,1ºC tras la intervención (p=0,05). Se identificó la reducción de un punto (p=0,001) en la escala de dolor. DISCUSIÓN: La musicoterapia tiene efectos beneficiosos en cuanto a la reducción de la FR, FC y el nivel de dolor, así como también, un aumento de la saturación de oxígeno y temperatura axilar. CONCLUSIÓN: La musicoterapia interfiere positivamente en las respuestas fisiológicas del RNP con ventilación no invasiva.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Recém-Nascido Prematuro , Ventilação não Invasiva , Monitorização Fisiológica , Musicoterapia , Unidades de Terapia Intensiva Neonatal , Cuidado da Criança , Saúde da Criança , Hospitais Universitários
11.
J Med Microbiol ; 70(5)2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33956591

RESUMO

Introduction. Clinical microbiology laboratories have had to cope with an increase in the volume of tests due to the emergence of the SARS-CoV-2 virus. Short turnaround times (TATs) are important for case tracing and to help clinicians in patient management. In such a context, high-throughput systems are essential to process the bulk of the tests. Rapid tests are also required to ensure shorter TATs for urgent situations. In our laboratory, SARS-CoV-2 assays were initially implemented on our custom platform using a previously published method. The commercial cobas 6800 (Roche diagnostics) assay and the GeneXpert Xpress (Cepheid) SARS-CoV-2 assay were implemented on 24 March and 8 April 2020, respectively, as soon as available.Hypothesis/Gap Statement. Despite the abundant literature on SARS-CoV-2 assays, the articles focus mainly on the diagnostic performances. This is to our knowledge the first article that specifically studies the TAT of different assays.Aim. We aimed to describe the impact of various SARS-CoV-2 assays on the TAT at the beginning of the outbreak.Methodology. In this study, we retrospectively analysed the TAT of all SARS-CoV-2 assays performed in our centre between 24 February and 9 June, 2020.Results. We retrieved 33 900 analyses, with a median TAT of 6.25 h. TATs were highest (6.9 h) when only our custom platform was used (24 February to 24 March, 2020). They were reduced to 6.1 h when the cobas system was introduced (24 March to 8 April, 2020). The implementation of the GeneXpert further reduced the median TAT to 4.8 h (8 April to 9 June, 2020). The GeneXpert system had the shortest median TAT (1.9 h), followed by the cobas (5.5 h) and by our custom platform (6.9 h).Conclusion. This work shows that the combination of high-throughput systems and rapid tests allows the efficient processing of a large number of tests with a short TAT. In addition, the use of a custom platform allowed the quick implementation of an in-house test when commercial assays were not yet available.


Assuntos
/diagnóstico , /isolamento & purificação , Busca de Comunicante , Ensaios de Triagem em Larga Escala , Hospitais Universitários , Humanos , Estudos Retrospectivos , Suíça , Fatores de Tempo
12.
Medicine (Baltimore) ; 100(18): e25737, 2021 May 07.
Artigo em Inglês | MEDLINE | ID: mdl-33950957

RESUMO

ABSTRACT: Hospital overcrowding has led to a practice known as bedspacing (in which admitted patients are placed on a different specialty's inpatient ward), yet little is known about the impact of this practice on healthcare quality.We investigated whether hospital outcome measures differ between bedspaced general internal medicine (GIM) patients vs nonbedspaced patients.Our retrospective study included patients admitted to GIM wards at 2 academic hospitals (2012-2014), comparing bedspaced to nonbedspaced patients, and identifying adverse events from the hospital's Electronic Patient Record.We compared these groups with respect to actual length of stay vs the expected length of stay (% ELOS), which is defined as length of stay (LOS) divided by expected length of stay (ELOS), 30-day readmission, adverse events (falls, medication-related incidents, equipment-related incidents, first treatment related incidents, laboratory-related incidents, and operative/invasive events), and in-hospital mortality.There were 22,519 patients analyzed with 15,985 (71%) discharged from a medical ward and 6534 (29%) discharged from a non-medical ward. Bedspaced patients had shorter lengths of stay (4.1 vs 6.2 days, P < .001) and expected lengths of stay (ELOS) (6.1 vs 6.4 days, P < .001). Bedspaced patients had a lower percentage of ELOS (% ELOS) than nonbedspaced patients (70% vs 91%, P < .001), similar readmission rates (9.8 vs 10.3 events per 100 patients, P = .24), lower in-hospital mortality rates (2.6 vs 3.3 events per 100 patients, P = .003) and fewer adverse events (0.20 vs 0.60 events per 100 patient days, P < .01).Bedspacing of patients is common. Patients who are bedspaced to off-service wards have better outcomes. This may relate to preferential allocation practices.


Assuntos
Hospitais Universitários/organização & administração , Medicina Interna/organização & administração , Admissão do Paciente/estatística & dados numéricos , Qualidade da Assistência à Saúde/estatística & dados numéricos , Centros de Atenção Terciária/organização & administração , Idoso , Idoso de 80 Anos ou mais , Feminino , Número de Leitos em Hospital/estatística & dados numéricos , Mortalidade Hospitalar , Hospitais Universitários/estatística & dados numéricos , Humanos , Medicina Interna/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Readmissão do Paciente/estatística & dados numéricos , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricos
14.
BMC Health Serv Res ; 21(1): 468, 2021 May 18.
Artigo em Inglês | MEDLINE | ID: mdl-34006279

RESUMO

BACKGROUND: Prediction of the necessary capacity of beds by ward type (e.g. ICU) is essential for planning purposes during epidemics, such as the COVID- 19 pandemic. The COVID- 19 taskforce within the Ghent University hospital made use of ten-day forecasts on the required number of beds for COVID- 19 patients across different wards. METHODS: The planning tool combined a Poisson model for the number of newly admitted patients on each day with a multistate model for the transitions of admitted patients to the different wards, discharge or death. These models were used to simulate the required capacity of beds by ward type over the next 10 days, along with worst-case and best-case bounds. RESULTS: Overall, the models resulted in good predictions of the required number of beds across different hospital wards. Short-term predictions were especially accurate as these are less sensitive to sudden changes in number of beds on a given ward (e.g. due to referrals). Code snippets and details on the set-up are provided to guide the reader to apply the planning tool on one's own hospital data. CONCLUSIONS: We were able to achieve a fast setup of a planning tool useful within the COVID- 19 pandemic, with a fair prediction on the needed capacity by ward type. This methodology can also be applied for other epidemics.


Assuntos
Pandemias , Número de Leitos em Hospital , Hospitais Universitários , Humanos , Unidades de Terapia Intensiva , Pandemias/prevenção & controle
15.
Stud Health Technol Inform ; 281: 402-406, 2021 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-34042774

RESUMO

HiGHmed is a German Consortium where eight University Hospitals have agreed to the cross-institutional data exchange through novel medical informatics solutions. The HiGHmed Use Case Infection Control group has modelled a set of infection-related data in the openEHR format. In order to establish interoperability with the other German Consortia belonging to the same national initiative, we mapped the openEHR information to the Fast Healthcare Interoperability Resources (FHIR) format recommended within the initiative. FHIR enables fast exchange of data thanks to the discrete and independent data elements into which information is organized. Furthermore, to explore the possibility of maximizing analysis capabilities for our data set, we subsequently mapped the FHIR elements to the Observational Medical Outcomes Partnership Common Data Model (OMOP CDM). The OMOP data model is designed to support the conduct of research to identify and evaluate associations between interventions and outcomes caused by these interventions. Mapping across standard allows to exploit their peculiarities while establishing and/or maintaining interoperability. This article provides an overview of our experience in mapping infection control related data across three different standards openEHR, FHIR and OMOP CDM.


Assuntos
Informática Médica , Registros Eletrônicos de Saúde , Hospitais Universitários , Humanos
16.
Cir Esp ; 99(5): 368-373, 2021 May.
Artigo em Espanhol | MEDLINE | ID: mdl-34024916

RESUMO

Introduction: SARS-CoV-2 pandemic has caused an important impact in our country and elective surgery has been postponed in most cases. There's not known information about the decreasing and impact on surgery. Mortality of surgical patients with SARS-CoV-2 infection is estimated to be around 20%. Methods: We conducted prospective data recruitment of people inpatient in our Digestive and General Surgery section of Girona's University Hospital Dr. Josep Trueta from 03/14 to 05/11. Our objective is to analyze the impact that SARS-CoV-2 pandemic over elective and urgent surgery. Results: During the peak occupation of our center Intensive Care Unit (303.8%) there was a reduction on elective (93.8%) and urgent (72.7%) surgery. Mortality of patients with SARS-CoV-2 infection who underwent surgery (n = 10) is estimated to be a 10%. An 80% of these patients suffer complications (sever complications in 30%). Conclusions: The actual study shows a global reduction of the surgical activity (elective and urgent) during de SARS-CoV-2 pandemic. Global mortality of patients with SARS-CoV-2 infection are low, but the severe complications have been over the usual.


Assuntos
/epidemiologia , Procedimentos Cirúrgicos Eletivos/tendências , Emergências , Hospitais Universitários , Procedimentos Cirúrgicos Operatórios/tendências , Ocupação de Leitos , Colecistectomia , Colectomia , Doenças do Colo/cirurgia , Tratamento Conservador/tendências , Drenagem , Feminino , Doenças da Vesícula Biliar/cirurgia , Humanos , Unidades de Terapia Intensiva , Isquemia/cirurgia , Masculino , Pessoa de Meia-Idade , Pancreatite/cirurgia , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Espanha
17.
BMC Med Educ ; 21(1): 295, 2021 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-34024279

RESUMO

BACKGROUND: Microsurgical techniques are an important part of clinical and experimental research. Here we present our step-by-step microsurgery training course developed at the Münster University Hospital. The goal of this course was to create a short, modular curriculum with clearly described and easy to follow working steps in accordance with the Guidelines for Training in Surgical Research in Animals by the Academy of Surgical Research. METHODS: Over the course of 10 years, we conducted an annual 2.5 day (20 h) microsurgical training course with a total of 120 participants. RESULTS: Prior to the course, 90% of the participants reported to have never performed a microanastomosis before. During the 10 years a total of 84.2% of the participants performed microanastomoses without assistance, 15% required assistance and only 0.8% failed. CONCLUSIONS: Our step-by-step microsurgery training course gives a brief overview of the didactic basics and the organization of a microsurgical training course and could serve as a guide for teaching microsurgical skills. During the 2.5-day curriculum, it was possible to teach, and for participants to subsequently perform a microsurgical anastomosis. The independent reproducibility of the learned material after the course is not yet known, therefore further investigations are necessary. With this step-by-step curriculum, we were able to conduct a successful training program, shown by the fact that each participant is able to perform microvascular anastomoses on a reproducible basis.


Assuntos
Currículo , Microcirurgia , Anastomose Cirúrgica , Animais , Competência Clínica , Hospitais Universitários , Humanos , Reprodutibilidade dos Testes
19.
Clin Dermatol ; 39(1): 23-32, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33972048

RESUMO

The first cases of coronavirus disease 2019 (COVID-19) in Iran were detected on February 19, 2020. Soon the entire country was hit with the virus. Although dermatologists were not immediately the frontline health care workers, all aspects of their practice were drastically affected. Adapting to this unprecedented crisis required urgent appropriate responses. With preventive measures and conserving health care resources being the most essential priorities, dermatologists, as an integral part of the health system, needed to adapt their practices according to the latest guidelines. The spectrum of the challenges encompassed education, teledermatology, lasers, and other dermatologic procedures, as well as management of patients who were immunosuppressed or developed drug reactions and, most importantly, the newly revealed cutaneous signs of COVID-19. These challenges have paved the way for new horizons in dermatology.


Assuntos
/epidemiologia , Dermatologia/normas , Hospitais Universitários , Dermatopatias/etiologia , Dermatopatias/terapia , /complicações , Técnicas Cosméticas , Dermatite/etiologia , Procedimentos Cirúrgicos Dermatológicos , Dermatologia/educação , Dermatologia/métodos , Dermoscopia , Erupção por Droga/etiologia , Dermatoses da Mão/etiologia , Desinfecção das Mãos , Humanos , Internato e Residência , Irã (Geográfico)/epidemiologia , Terapia a Laser , Equipamento de Proteção Individual/efeitos adversos , Fototerapia , Guias de Prática Clínica como Assunto , Prática Privada , Dermatopatias/tratamento farmacológico , Telemedicina
20.
Emergencias ; 33(3): 174-180, 2021 06.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33978330

RESUMO

OBJECTIVES: We aimed to analyze the clinical course of patients discharged from our emergency departament (ED) with pneumonia symptoms compatible with a diagnosis of COVID-19. MATERIAL AND METHODS: We followed 102 patients discharged home with a diagnosis of pneumonia compatible with COVID19 between March 12 and 21, 2020, in our hospital in the southern part of the autonomous community of Madrid. Descriptive statistics (medians and interquartile ranges or frequencies, as appropriate) were compiled for the main variables. Treatments and prognoses were compared with 􀁆2, Kruskal-Wallis, or Mann-Whitney tests. The data then underwent logistic regression analysis. RESULTS: Most patients (accounting for 74.5% of the discharges) were treated with hydroxychloroquine alone. The readmission rate was 15.7%; the ED revisiting rate was 25.7%. Admission was associated with an elevated lactate dehydrogenase (LDH) level (P=.011), elevated creatine kinase (CK) (P=.004), and lymphopenia (P=.034). Hypertension and chronic obstructive pulmonary disease were also related to admission. Ischemic heart disease was associated with longer duration of symptoms. CONCLUSION: Lymphopenia, and elevated LDH and CK levels predicted the need for hospital admission better than other traditional biological markers in patients with mild to moderate symptoms. Telephone follow-up proved useful for dealing with the overloading of health care services.


Assuntos
/sangue , Creatina Quinase/sangue , L-Lactato Desidrogenase/sangue , Contagem de Linfócitos , Adulto , Idoso , Antivirais/uso terapêutico , Biomarcadores , /epidemiologia , Comorbidade , Feminino , Seguimentos , Hospitais Universitários/estatística & dados numéricos , Humanos , Hidroxicloroquina/uso terapêutico , Hipertensão/epidemiologia , Linfopenia/sangue , Linfopenia/etiologia , Masculino , Pessoa de Meia-Idade , Isquemia Miocárdica/epidemiologia , Alta do Paciente , Readmissão do Paciente/estatística & dados numéricos , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Espanha/epidemiologia , Telefone
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