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Acad Med ; 95(10): 1495-1498, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32304386


The COVID-19 pandemic has stretched health care resources to a point of crisis throughout the world. To answer the call for care, health care workers in a diverse range of specialties are being retasked to care for patients with COVID-19. Consequently, specialty services have had to adapt to decreased staff available for coverage coupled with a need to remain available for specialty-specific emergencies, which now require a dynamic definition. In this Invited Commentary, the authors describe their experiences and share lessons learned regarding triage of patients, staff safety, workforce management, and the psychological impact as they have adapted to a new reality in the Department of Neurosurgery at Montefiore Medical Center, a COVID-19 hot spot in New York City.

Infecções por Coronavirus , Assistência à Saúde/organização & administração , Mão de Obra em Saúde/organização & administração , Medicina/organização & administração , Pandemias , Administração de Recursos Humanos/métodos , Pneumonia Viral , Betacoronavirus , Humanos , Cidade de Nova Iorque/epidemiologia
Endocrinol. diabetes nutr. (Ed. impr.) ; 66(10): 654-662, dic. 2019.
Artigo em Espanhol | IBECS | ID: ibc-184793


Las enfermedades endocrinas están experimentando un importante incremento de su prevalencia, debido a causas de diversa índole, entre ellas la epidemia de obesidad y de desnutrición, el envejecimiento de la población, pero también el efecto de los disruptores endocrinos, entre otros. Por otra parte, las nuevas tecnologías, tanto a nivel de analítica molecular y genética, de imagen y de nuevos dispositivos terapéuticos, obligan a que la comunidad profesional endocrina en España tenga que estar en constante formación. La conexión con los pacientes a través de sus asociaciones, cada vez más activas, y con la sociedad civil en general, el compromiso profesional y la demanda de diversos colectivos sociales de una atención moderna y equitativa, y a llevar a cabo investigación que facilite la consecución de avances para los pacientes, obligan al especialista en Endocrinología y Nutrición, y a la Sociedad Española de Endocrinología y Nutrición (SEEN), a posicionarse y dar respuesta a todos estos retos. En el presente documento, la SEEN expone sus propuestas y su estrategia hasta el 2022

Endocrine diseases are experiencing an important increase in their prevalence, due to causes of various kinds, including the epidemic of obesity and malnutrition, the aging of the population, but also the effect of endocrine disruptors, among others. On the other hand, new technologies, both in terms of molecular and genetic analysis, image and new therapeutic devices, require that the endocrine professional community in Spain must be in constant training. The connection with patients through their associations, increasingly active, and with the civil society in general, the professional commitment and demand of various social groups for a modern and equitable care, and to carry out research that facilitates the achievement of advances for patients, forces the specialist in endocrinology and nutrition and the Spanish Society of Endocrinology and Nutrition (SEEN) to position themselves and respond to all these challenges. In this document, the SEEN presents its proposals and its strategy until 2022

Endocrinologia/organização & administração , Sociedades Médicas/organização & administração , Sociedades Médicas/tendências , Estratégias , Endocrinologia/tendências , Sistemas Nacionais de Saúde , Medicina/organização & administração , Promoção da Saúde , Espanha
Dtsch Med Wochenschr ; 144(22): e145-e152, 2019 11.
Artigo em Alemão | MEDLINE | ID: mdl-31648356


The 3-Country-Manifest extends beyond existing oaths, vows and codices. It is supposed to encourage discussion and close the gap in the conflict between medical-ethical principles and a dangerous development through economisation, commercialisation and industrialisation of the patient care.Ten demands are raised to clarify the medical profession's urgent concerns due to economic, technological and medical-ethical developments and as a result ensure that patient welfare will remain the pivotal measure of medicine in the future.The Physicians 3-Country-Manifest addresses concrete suggestions and topics as a starting point for a change in awareness and attitude in all interest groups in health care. It wants to accomplish the necessary turning point towards humanely designed medical care.

Desenvolvimento Industrial , Medicina , Assistência ao Paciente , Humanos , Medicina/organização & administração , Medicina/normas , Assistência ao Paciente/economia , Assistência ao Paciente/ética , Assistência ao Paciente/tendências , Médicos
Inquiry ; 56: 46958019856975, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31189387


The objective of this study was to investigate and describe how the use of the term "elderly" contributes to bias and problems within the medical system. A systematic review of the relevant literature and history was conducted. The term "elderly" does not define age accurately and carries bias and prejudice that lead to harm through discriminatory practices, institutional prejudices, and "ageist" policies in society and medicine. Doctors and healthcare providers seldom intentionally try to harm any patient, but might do so through unconscious anti-elderly bias. Studies indicate that medical students already demonstrate anti-elderly bias; researchers may lump patients aged 65 and over together, confounding specific information needed for individualized treatments; and out of unwarranted concern, medical and surgical treatments may be denied, despite minimal increased risk of mortality. When the cost of healthcare rises, it is the elderly against whom rationing is suggested. The term "elderly" has no place in medicine. Anti-elderly health care rationing is as unethical as rationing targeted against any group. It is reverse paternalism to make rules that limit others' medical care, happiness, and life span without their consent. Medicine is the science and art of individual communication, evaluation and treatment. Once we deny care to any one group, we open the door to denial to others.

Envelhecimento/ética , Medicina , Preconceito , Discriminação Social/ética , Idoso , Comunicação , Assistência à Saúde , Alocação de Recursos para a Atenção à Saúde/ética , Humanos , Medicina/organização & administração
Mol Genet Metab ; 127(2): 122-127, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31138493


The mitochondrial medicine society (MMS) has previously highlighted the clinical landscape and physician practice patterns of mitochondrial medicine in the US and attempted to develop consensus criteria for diagnosis and management to improve patient coordinated care. Most recently, and in collaboration with US-based patient advocacy groups, we developed a clinical care network to formally unify US-based clinicians who provide medical care to individuals with mitochondrial disease; to define, design and implement best practices in mitochondrial medicine building on the current consensus guidelines and to improve patients' clinical outcomes. Here we review the steps taken in collaboration with several stakeholders to develop goals and expectations for a mitochondrial care network (MCN), criteria for MCN site selection and formal launch of the network.

Serviços de Informação/organização & administração , Doenças Mitocondriais/terapia , Doenças Raras/terapia , Humanos , Medicina/organização & administração , Doenças Mitocondriais/diagnóstico , Participação dos Interessados , Estados Unidos
J Fr Ophtalmol ; 42(4): 349-353, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30905439


PURPOSE: To investigate and compare the h-indices of the editorial board members of ophthalmic subspecialty journals. STUDY DESIGN: Descriptive Cross Sectional Research. METHODS: Bibliometric indices were calculated for the editorial board members of seven ophthalmic subspecialty journals. Correlations between the median h-indexes and journal impact factors (JIF), average citations per article and JIF, and publication count and JIF were analyzed. RESULTS: The median h-indices of the board members of Retina, Journal of Glaucoma, Journal of Cataract and Refractive Surgery, Cornea, Ophthalmic Plastic and Reconstructive Surgery, Journal of Neuroophthalmology and Journal of the American Academy of Pediatric Ophthalmology and Strabismus (J AAPOS) were 34, 26, 23, 17, 15, 14 and 13, respectively. H-indices and publication count were correlated with JIF (P<0.05, for each). CONCLUSION: The board members of Retina have the highest h-index and average citations per article, and J AAPOS have the least. These data provide useful benchmarks for comparison of the various subspecialty areas in ophthalmology.

Fator de Impacto de Revistas , Oftalmologia/organização & administração , Publicações Periódicas como Assunto , Editoração , Estudos Transversais , Políticas Editoriais , Conselho Diretor/normas , Humanos , Medicina/organização & administração , Oftalmologia/classificação , Oftalmologia/normas , Publicações Periódicas como Assunto/normas , Editoração/organização & administração , Editoração/normas , Estados Unidos