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1.
BMC Med ; 18(1): 398, 2020 12 16.
Artigo em Inglês | MEDLINE | ID: mdl-33323116

RESUMO

BACKGROUND: Dementia is caused by a variety of neurodegenerative diseases and is associated with a decline in memory and other cognitive abilities, while inflicting an enormous socioeconomic burden. The complexity of dementia and its associated comorbidities presents immense challenges for dementia research and care, particularly in clinical decision-making. MAIN BODY: Despite the lack of disease-modifying therapies, there is an increasing and urgent need to make timely and accurate clinical decisions in dementia diagnosis and prognosis to allow appropriate care and treatment. However, the dementia care pathway is currently suboptimal. We propose that through computational approaches, understanding of dementia aetiology could be improved, and dementia assessments could be more standardised, objective and efficient. In particular, we suggest that these will involve appropriate data infrastructure, the use of data-driven computational neurology approaches and the development of practical clinical decision support systems. We also discuss the technical, structural, economic, political and policy-making challenges that accompany such implementations. CONCLUSION: The data-driven era for dementia research has arrived with the potential to transform the healthcare system, creating a more efficient, transparent and personalised service for dementia.


Assuntos
Biologia Computacional/tendências , Procedimentos Clínicos , Bases de Dados Factuais/provisão & distribução , Demência/terapia , Neurologia/tendências , Big Data/provisão & distribução , Comorbidade , Biologia Computacional/métodos , Biologia Computacional/organização & administração , Procedimentos Clínicos/organização & administração , Procedimentos Clínicos/normas , Procedimentos Clínicos/estatística & dados numéricos , Ciência de Dados/métodos , Ciência de Dados/organização & administração , Ciência de Dados/tendências , Demência/epidemiologia , Humanos , Neurologia/métodos , Neurologia/organização & administração
4.
Clin Neurol Neurosurg ; 197: 106156, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32877768

RESUMO

The COVID-19 pandemic dramatically affected the operations of New York City hospitals during March and April of 2020. This article describes the transformation of a neurology division at a 450-bed tertiary care hospital in a multi-ethnic community in Brooklyn during this initial wave of COVID-19. In lieu of a mass redeployment of staff to internal medicine teams, we report a novel method for a neurology division to participate in a hospital's expansion of care for patients with COVID-19 while maintaining existing team structures and their inherent supervisory and interpersonal support mechanisms.


Assuntos
Infecções por Coronavirus/terapia , Departamentos Hospitalares/organização & administração , Neurologia/organização & administração , Admissão e Escalonamento de Pessoal , Pneumonia Viral/terapia , Betacoronavirus , Cuidados Críticos/organização & administração , Eletroencefalografia/métodos , Hospitais Urbanos , Humanos , Internato e Residência/organização & administração , Enfermagem em Neurociência/organização & administração , Cidade de Nova Iorque , Pandemias , Provedores de Redes de Segurança , Centros de Atenção Terciária
5.
Rev. neurol. (Ed. impr.) ; 71(6): 199-204, 16 sept., 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-195512

RESUMO

INTRODUCCIÓN: Las consultas por cefalea son el motivo más frecuente de demanda de atención de causa neurológica en la atención primaria y en los servicios de neurología. Las unidades de cefalea mejoran la calidad asistencial, reducen las listas de espera, facilitan el acceso a nuevos tratamientos de eficacia contrastada y optimizan el gasto sanitario. No obstante, la implantación de estas unidades no está extendida en España debido a la relativa importancia atribuida a la patología y a la suposición de que su coste es elevado. OBJETIVO: Definir la estructura y los requerimientos mínimos de una unidad de cefalea con la intención de contribuir a su extensión en los hospitales de España. SUJETOS Y MÉTODOS: Estudio de consenso entre profesionales tras la revisión de la bibliografía sobre la estructura, las funciones y los recursos de una unidad de cefalea para un área de 350.000 habitantes. RESULTADOS: Se tomaron como referencia ocho publicaciones para la identificación de recursos mínimos necesarios de una unidad de cefalea. El panel de expertos estuvo integrado por 12 profesionales de diferentes especialidades. El principal recurso para la implementación de estas unidades son profesionales (superiores y técnicos), lo que puede suponer un coste adicional para el primer año de alrededor de 107.287,19 euros. CONCLUSIONES: Si consideramos los costes directos e indirectos debidos a las pérdidas por productividad laboral por paciente y los comparamos con los costes estimados de implantación de estas unidades y su expectativa de resultados, todo apunta a que es necesaria la generalización de unidades de cefalea en España


INTRODUCTION: Visits due to headaches are the most frequent cause of demand for neurological treatment in primary care and neurology services. Headache units improve the quality of care, reduce waiting lists, facilitate access to new treatments of proven efficacy and optimise healthcare expenditure. However, these units have not been implemented on a widespread basis in Spain due to the relatively low importance attributed to the condition and also the assumption that such units have a high cost. AIM: To define the structure and minimum requirements of a headache unit with the intention of contributing to their expansion in hospitals in Spain. SUBJECTS AND METHODS: We conducted a consensus study among professionals after reviewing the literature on the structure, functions and resources required by a headache unit designed to serve an area with 350,000 inhabitants. RESULTS: Eight publications were taken as a reference for identifying the minimum resources needed for a headache unit. The panel of experts was made up of 12 professionals from different specialties. The main resource required to be able to implement these units is the professional staff (both supervisory and technical), which can mean an additional cost for the first year of around 107,287.19 euros. CONCLUSIONS: If we bear in mind the direct and indirect costs due to losses in labour productivity per patient and compare them with the estimated costs involved in implementing these units and their expected results, everything points to the need for headache units to become generalised in Spain


Assuntos
Humanos , Cefaleia/epidemiologia , Unidades Hospitalares/organização & administração , Neurologia/organização & administração , Necessidades e Demandas de Serviços de Saúde/economia , Necessidades e Demandas de Serviços de Saúde/organização & administração , Qualidade da Assistência à Saúde/organização & administração , Unidades Hospitalares/economia , Espanha/epidemiologia , Neurologia/economia , Consenso , Pesquisa Qualitativa
6.
Rinsho Shinkeigaku ; 60(10): 643-652, 2020 Oct 24.
Artigo em Japonês | MEDLINE | ID: mdl-32814728

RESUMO

Disaster countermeasures have been implemented by the Japanese Society of Neurology based on the experience of support to the areas affected by the Great East Japan Earthquake on March 11, 2011. The countermeasures activity began at the end of 2011. We, the Committee for Measures Against Disaster, officially started work in 2014. We developed a support network to urgently deal with patients with intractable neurological disease at the time of disaster and strengthen disaster measures, including effective disaster countermeasure training. During the 2016 Kumamoto earthquake, we realized the need to prepare for natural disasters, leading to a state of emergency, at normal times. A list of vulnerable people should be prepared and the individual support plan for disaster should be confirmed during normal times. Furthermore, during disaster, livelihood support is required for patients with intractable neurological disease living in evacuation centers in affected areas. Therefore, we compiled and published the book, titled "The manual of disaster countermeasures," in 2017. The Committee for Measures Against Disaster in the Japanese Society of Neurology has appointed a liaison officer for patients with intractable neurological disease in each prefecture. The liaison's role of is gathering and disseminating information on the disaster-hit areas, arranging medical support, and coordinating health activities, when natural disasters occur. It is hoped that the liaison officer will play an active role both at normal times and during disaster, even unforeseen ones. Although we hope for the best, we aim to be prepared for the worst.


Assuntos
Serviços de Saúde Comunitária , Planejamento em Desastres/métodos , Terremotos , Pessoal de Saúde , Manuais como Assunto , Doenças do Sistema Nervoso , Neurologia/organização & administração , Papel Profissional , Sociedades Médicas/organização & administração , Humanos , Japão
7.
Neurology ; 95(13): 583-592, 2020 09 29.
Artigo em Inglês | MEDLINE | ID: mdl-32732292

RESUMO

In response to the COVID-19 pandemic epicenter in Bronx, NY, the Montefiore Neuroscience Center required rapid and drastic changes when considering the delivery of neurologic care, health and safety of staff, and continued education and safety for house staff. Health care leaders rely on principles that can be in conflict during a disaster response such as this pandemic, with equal commitments to ensure the best care for those stricken with COVID-19, provide high-quality care and advocacy for patients and families coping with neurologic disease, and advocate for the health and safety of health care teams, particularly house staff and colleagues who are most vulnerable. In our attempt to balance these principles, over 3 weeks, we reformatted our inpatient neuroscience services by reducing from 4 wards to just 1, in the following weeks delivering care to over 600 hospitalized patients with neuro-COVID and over 1,742 total neuroscience hospital bed days. This description from members of our leadership team provides an on-the-ground account of our effort to respond nimbly to a complex and evolving surge of patients with COVID in a large urban hospital network. Our efforts were based on (1) strategies to mitigate exposure and transmission, (2) protection of the health and safety of staff, (3) alleviation of logistical delays and strains in the system, and (4) facilitating coordinated communication. Each center's experience will add to knowledge of best practices, and emerging research will help us gain insights into an evidence-based approach to neurologic care during and after the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus , Departamentos Hospitalares/organização & administração , Corpo Clínico Hospitalar/organização & administração , Neurologia/organização & administração , Pandemias , Pneumonia Viral , Assistência Ambulatorial , Betacoronavirus , Comunicação , Assistência à Saúde , Unidades Hospitalares/organização & administração , Hospitalização , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Neurologia/educação , Enfermagem em Neurociência , Recursos Humanos de Enfermagem no Hospital/organização & administração , Equipamento de Proteção Individual , Admissão e Escalonamento de Pessoal , Telemedicina , Envio de Mensagens de Texto
8.
Neurología (Barc., Ed. impr.) ; 35(6): 372-380, jul.-ago. 2020. tab, mapas
Artigo em Espanhol | IBECS | ID: ibc-189802

RESUMO

INTRODUCCIÓN: La sobrecarga asistencial y los cambios organizativos frente a la pandemia de COVID-19 podrían estar repercutiendo en la atención al ictus agudo en la Comunidad de Madrid. MÉTODOS: Encuesta estructurada en bloques: características del hospital, cambios en infraestructura y recursos, circuitos de código ictus, pruebas diagnósticas, rehabilitación y atención ambulatoria. Análisis descriptivo según el nivel de complejidad en la atención del ictus (disponibilidad o no de unidad de ictus y de trombectomía mecánica). RESULTADOS: De los 26 hospitales del SERMAS que atienden urgencias en adultos, 22 cumplimentaron la encuesta entre el 16 y 27 de abril. El 95% han cedido neurólogos para atender a pacientes afectados por la COVID-19. Se han reducido camas de neurología en el 89,4%, modificado los circuitos en urgencias para ictus en el 81%, con circuitos específicos para sospecha de infección por SARS-CoV2 en el 50%, y en el 42% de los hospitales los pacientes con ictus agudo positivos para SARS-CoV2 no ingresan en camas de neurología. Ha mejorado el acceso al tratamiento, con trombectomía mecánica las 24 h en el propio hospital en 10 hospitales, y se han reducido los traslados interhospitalarios secundarios. Se ha evitado el ingreso de pacientes con ataque isquémico transitorio o ictus leve (45%) y se han incorporado consultas telefónicas para seguimiento en el 100%. CONCLUSIONES: Los cambios organizativos de los hospitales de la Comunidad de Madrid frente a la pandemia por SARS-Co2 han modificado la dedicación de recursos humanos e infraestructuras de las unidades de neurología y los circuitos de atención del ictus, realización de pruebas diagnósticas, ingreso de los pacientes y seguimiento


INTRODUCTION: The overload of the healthcare system and the organisational changes made in response to the COVID-19 pandemic may be having an impact on acute stroke care in the Region of Madrid. METHODS: We conducted a survey with sections addressing hospital characteristics, changes in infrastructure and resources, code stroke clinical pathways, diagnostic testing, rehabilitation, and outpatient care. We performed a descriptive analysis of results according to the level of complexity of stroke care (availability of stroke units and mechanical thrombectomy). RESULTS: The survey was completed by 22 of the 26 hospitals in the Madrid Regional Health System that attend adult emergencies, between 16 and 27 April 2020. Ninety-five percent of hospitals had reallocated neurologists to care for patients with COVID-19. The numbers of neurology ward beds were reduced in 89.4% of hospitals; emergency department stroke care pathways were modified in 81%, with specific pathways for suspected SARS-CoV2 infection established in 50% of hospitals; and SARS-CoV2-positive patients with acute stroke were not admitted to neurology wards in 42%. Twenty-four hour on-site availability of mechanical thrombectomy was improved in 10 hospitals, which resulted in a reduction in the number of secondary hospital transfers. The admission of patients with transient ischaemic attack or minor stroke was avoided in 45% of hospitals, and follow-up through telephone consultations was implemented in 100%. CONCLUSIONS: The organisational changes made in response to the SARS-Co2 pandemic in hospitals in the Region of Madrid have modified the allocation of neurology department staff and infrastructure, stroke units and stroke care pathways, diagnostic testing, hospital admissions, and outpatient follow-up


Assuntos
Humanos , Adulto , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Betacoronavirus , Pandemias , Prioridades em Saúde , Acidente Vascular Cerebral/terapia , Administração Hospitalar , Neurologia/organização & administração , Teleneurologia , Espanha
9.
Clin Med (Lond) ; 20(5): e173-e177, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32719035

RESUMO

We describe the details of a COVID-19 outbreak in a 25-bedded Birmingham neurology/stroke ward in the early phase of the pandemic (March to May 2020). Twenty-one of 133 admissions (16%) tested positive for COVID-19 and of those, 8 (6% of all admissions to the ward) were determined to be nosocomial. Thus 38% (8/21) of COVID-19 infections were hospital-acquired. Ten of the patients that contracted COVID-19 died; of these three were hospital-acquired cases. Five of the 21 patients had negative swabs prior to receiving a positive test result. This study highlights the importance of appropriate use of personal protective equipment (PPE) with high-risk patients (including those with stroke and complex brain injury with tracheostomies) and the difficulties of COVID-19 management in a high-risk patient population.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/epidemiologia , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Acidente Vascular Cerebral/epidemiologia , Infecções por Coronavirus/epidemiologia , Infecção Hospitalar/prevenção & controle , Feminino , Departamentos Hospitalares , Hospitais de Distrito , Hospitais Gerais , Humanos , Incidência , Masculino , Auditoria Médica , Neurologia/organização & administração , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Reino Unido , Populações Vulneráveis
10.
Stroke Vasc Neurol ; 5(3): 260-269, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32641444

RESUMO

AIM: Stroke is characterised by high morbidity, mortality and disability, which seriously affects the health and safety of the people. Stroke has become a serious public health problem in China. Organisational stroke management can significantly reduce the mortality and disability rates of patients with stroke. We provide this evidence-based guideline to present current and comprehensive recommendations for organisational stroke management. METHODS: A formal literature search of MEDLINE (1 January 1997 through 30 September 2019) was performed. Data were synthesised with the use of evidence tables. Writing group members met by teleconference to discuss data-derived recommendations. The Chinese Stroke Association's Levels of Evidence grading algorithm was used to grade each recommendation. RESULTS: Evidence-based guidelines are presented for the organisational management of patients presenting with stroke. The focus of the guideline was subdivided into prehospital first aid system of stroke, rapid diagnosis and treatment of emergency in stroke centre, organisational management of stroke unit and stroke clinic, construction of regional collaborative network among stroke centres and evaluation and continuous improvement of stroke medical quality. CONCLUSIONS: The guidelines offer an organisational stroke management model for patients with stroke which might help dramatically.


Assuntos
Prestação Integrada de Cuidados de Saúde/normas , Medicina Baseada em Evidências/normas , Neurologia/normas , Reabilitação do Acidente Vascular Cerebral/normas , Acidente Vascular Cerebral/terapia , China/epidemiologia , Consenso , Prestação Integrada de Cuidados de Saúde/organização & administração , Avaliação da Deficiência , Medicina Baseada em Evidências/organização & administração , Humanos , Modelos Organizacionais , Neurologia/organização & administração , Recuperação de Função Fisiológica , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/epidemiologia , Resultado do Tratamento
11.
Rinsho Shinkeigaku ; 60(8): 515-519, 2020 Aug 07.
Artigo em Japonês | MEDLINE | ID: mdl-32641632

RESUMO

The Japanese Society of Neurology decided to aim to convert neurology, which is currently a subspecialty of internal medicine, to a basic specialty in the Japanese medical specialty system at the special general meeting of corporate members in January 2018. Because the details of new specialty system in Japan remain unstable, the committee to promote achievement of neurology as a basic specialty planned to hold a special symposium regarding the specialty system at the 60th annual meeting of the Japanese Society of Neurology in May 2019. This article compiles the abstracts of speakers in this symposium. Speakers were from Ministry of Health, Labour and Welfare, the Japan Medical Association, and our society members. We discussed the reason why neurology should be a basic specialty, the consideration indispensable for the regional health care as a basic specialty, how to reach our goal, and problems to overcome. Based on the decision at the special general meeting of corporate members mentioned above and such discussion, we will continue making best efforts to achieve neurology as a basic specialty through negotiation with relevant players including the Japanese Society of Internal Medicine.


Assuntos
Medicina/tendências , Neurologia , Sociedades Médicas/organização & administração , Congressos como Assunto , Humanos , Japão , Neurologia/organização & administração
13.
Neurologia ; 35(6): 363-371, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32563566

RESUMO

INTRODUCTION: The overload of the healthcare system and the organisational changes made in response to the COVID-19 pandemic may be having an impact on acute stroke care in the Region of Madrid. METHODS: We conducted a survey with sections addressing hospital characteristics, changes in infrastructure and resources, code stroke clinical pathways, diagnostic testing, rehabilitation, and outpatient care. We performed a descriptive analysis of results according to the level of complexity of stroke care (availability of stroke units and mechanical thrombectomy). RESULTS: The survey was completed by 22 of the 26 hospitals in the Madrid Regional Health System that attend adult emergencies, between 16 and 27 April 2020. Ninety-five percent of hospitals had reallocated neurologists to care for patients with COVID-19. The numbers of neurology ward beds were reduced in 89.4% of hospitals; emergency department stroke care pathways were modified in 81%, with specific pathways for suspected SARS-CoV2 infection established in 50% of hospitals; and SARS-CoV2-positive patients with acute stroke were not admitted to neurology wards in 42%. Twenty-four hour on-site availability of mechanical thrombectomy was improved in 10 hospitals, which resulted in a reduction in the number of secondary hospital transfers. The admission of patients with transient ischaemic attack or minor stroke was avoided in 45% of hospitals, and follow-up through telephone consultations was implemented in 100%. CONCLUSIONS: The organisational changes made in response to the SARS-Co2 pandemic in hospitals in the Region of Madrid have modified the allocation of neurology department staff and infrastructure, stroke units and stroke care pathways, diagnostic testing, hospital admissions, and outpatient follow-up.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Procedimentos Clínicos/organização & administração , Assistência à Saúde/organização & administração , Pandemias , Pneumonia Viral , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/terapia , Doença Aguda , Assistência Ambulatorial/organização & administração , Agendamento de Consultas , Conversão de Leitos , Infecções por Coronavirus/diagnóstico , Assistência à Saúde/estatística & dados numéricos , Serviço Hospitalar de Emergência/organização & administração , Pesquisas sobre Serviços de Saúde , Acesso aos Serviços de Saúde/estatística & dados numéricos , Número de Leitos em Hospital , Departamentos Hospitalares/organização & administração , Hospitais Urbanos/organização & administração , Hospitais Urbanos/estatística & dados numéricos , Humanos , Ataque Isquêmico Transitório/epidemiologia , Ataque Isquêmico Transitório/terapia , Trombólise Mecânica/estatística & dados numéricos , Neurologia/organização & administração , Admissão do Paciente/estatística & dados numéricos , Pneumonia Viral/diagnóstico , Espanha/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Reabilitação do Acidente Vascular Cerebral/estatística & dados numéricos , Telemedicina , Terapia Trombolítica/estatística & dados numéricos
15.
Clin Med (Lond) ; 20(4): e104-e106, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32518102

RESUMO

The COVID-19 pandemic will impact on how care for chronic conditions is delivered. We use epilepsy to exemplify how care for patients will be affected, and suggest ways in which healthcare systems can respond to deliver the most effective care. Where face-to-face outpatient appointments have been cancelled, telemedicine can facilitate remote clinical consultations for new and follow-up epilepsy clinic patients while reducing the risk of infection to both patients and healthcare staff. First-seizure patients will need investigation pathways rationalised, while those with chronic epilepsy will need to have reliable alternative avenues to access clinical advice. At the same time, neurologists should support emergency departments and acute medical units, advising on appropriate management of seizures and other acute neurological presentations. Ultimately, the revolution in our clinical practice is unlikely to cease after this pandemic, with reconfiguration of services likely to bring improvements in efficiency and convenience, and a reduced environmental impact.


Assuntos
Infecções por Coronavirus/complicações , Epilepsia/complicações , Epilepsia/tratamento farmacológico , Neurologia/organização & administração , Pneumonia Viral/complicações , Telemedicina , Anticonvulsivantes/provisão & distribução , Anticonvulsivantes/uso terapêutico , Doença Crônica , Serviço Hospitalar de Emergência , Epilepsia/diagnóstico , Epilepsia/etiologia , Humanos , Pandemias , Encaminhamento e Consulta
17.
AJNR Am J Neuroradiol ; 41(6): 960-965, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32354706

RESUMO

During the Severe Acute Respiratory Syndrome Coronavirus 2 (COVID-19) pandemic, neuroradiology practices have experienced a paradigm shift in practice, which affected everything from staffing, workflow, work volumes, conferences, resident and fellowship education, and research. This article highlights adaptive strategies that were undertaken at the epicenter of the outbreak in New York City during the past 4-6 weeks, as experienced by 5 large neuroradiology academic departments.


Assuntos
Infecções por Coronavirus , Neurologia/organização & administração , Pandemias , Pneumonia Viral , Radiologia/organização & administração , Fluxo de Trabalho , Betacoronavirus , Humanos , Cidade de Nova Iorque , Serviço Hospitalar de Radiologia/organização & administração
20.
Neurologia ; 35(4): 252-257, 2020 May.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32364126

RESUMO

INTRODUCTION: The COVID-19 pandemic will give rise to long-term changes in neurological care, which are not easily predictable. MATERIAL AND METHODS: A key informant survey was used to enquire about the changes expected in the specialty over the next 5 years. The survey was completed by heads of neurology departments with broad knowledge of the situation, having been active during the pandemic. RESULTS: Despite a low level of consensus between participants, there was strong (85%) and moderate consensus (70%) about certain subjects, mainly the increase in precautions to be taken, the use of telemedicine and teleconsultations, the reduction of care provided in in-person consultations to avoid the presence of large numbers of people in waiting rooms, the development of remote training solutions, and the changes in monitoring visits during clinical trials. There was consensus that there would be no changes to the indication of complementary testing or neurological examination. CONCLUSION: The key informant survey identified the foreseeable changes in neurological care after the pandemic.


Assuntos
Infecções por Coronavirus , Pesquisas sobre Serviços de Saúde , Doenças do Sistema Nervoso/terapia , Neurologia/tendências , Pandemias , Pneumonia Viral , Pessoal Administrativo/psicologia , Técnicas de Laboratório Clínico , Ensaios Clínicos como Assunto/métodos , Consenso , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Gerenciamento Clínico , Aconselhamento à Distância , Previsões , Departamentos Hospitalares/organização & administração , Humanos , Doenças do Sistema Nervoso/diagnóstico , Exame Neurológico , Neurologia/métodos , Neurologia/organização & administração , Pandemias/prevenção & controle , Isolamento de Pacientes , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Espanha/epidemiologia
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