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1.
Rev. venez. cir. ortop. traumatol ; 53(1): 35-41, jun. 2021. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1252919

RESUMO

El acortamiento y la rotación del peroné son las deformidades más frecuentemente encontradas cuando se presentan maluniones postraumáticas del tobillo resultando en ensanchamiento de la mortaja e inestabilidad astragalina, con consecuentes cambios artrósicos. Los pacientes acuden por presentar dolor y limitación en sus actividades diarias y deportivas. En el presente estudio retrospectivo se hace una evaluación de los resultados clínicos y radiológicos de 9 pacientes que se sometieron a tratamiento quirúrgico posterior a maluniones de fracturas de peroné, en los cuales se realizaron osteotomías de alargamiento y desrotación para reconstrucción del tobillo, en la Unidad de Cirugía de Pie y Tobillo del Hospital Universitario de Caracas, entre junio de 2014 y agosto del 2019. Se realizaron mediciones radiológicas pre y postoperatorias de los ángulos de inclinación astragalina, talocrural y bimaleolar, y se reportaron los cambios degenerativos articulares. Para la evaluación clínica y funcional se aplicó la Escala Análoga Visual (VAS) para el dolor, y la Escala AOFAS de retropié, evidenciándose mejoría en cuanto a dolor, función y alineación. El objetivo del tratamiento fue restituir la longitud inicial del peroné, mediante osteototomías oblicuas en el sitio de la fractura anterior, o transversas suprasindesmales, con lo cual también se corrige la alineación del astrágalo, y de esta manera prevenir o disminuir los síntomas y signos inherentes a degeneración articular progresiva(AU)


The shortening and rotation of the fibula are the most frequent deformities found when post-traumatic ankle malunions occur, resulting in widening of the mortise and talus instability, with consequent arthritic changes. Patients have pain and limitation in their daily activities and sports. In the present retrospective study, an evaluation of the clinical and radiological results of 9 patients who underwent surgical treatment after fibular fracture malunions was performed, in which osteotomies of lengthening and de-rotation were performed for reconstruction of the ankle, in the Unit of Foot and Ankle Surgery at the University Hospital of Caracas, between June 2014 and August 2019. Pre and postoperative radiological measurements of the astragaline, talocrural and bimaleolar inclination angles were performed, and degenerative joint changes were reported. For the clinical and functional evaluation, the Visual Analog Scale (VAS) was applied for pain, and the AOFAS Hindfoot Scale, evidencing improvement in pain, function, and alignment. The objective of the treatment was to restore the initial length of the fibula by means of oblique osteotomies at the site of the previous fracture or suprasindesmal transverse osteotomy, which also corrects the alignment of the talus and thus prevents or decreases the symptoms and signs inherent to joint progressive degeneration(AU)


Assuntos
Humanos , Masculino , Adulto , Pessoa de Meia-Idade , Idoso , Osteotomia , Alongamento Ósseo , Fraturas Mal-Unidas , Traumatologia , Fraturas Ósseas , Fíbula/cirurgia
2.
Rev. venez. cir. ortop. traumatol ; 53(1): 27-34, jun. 2021. tab
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1252908

RESUMO

Las técnicas quirúrgicas mínimamente invasivas ayudan a que el proceso natural de la consolidación ósea ocurra proporcionando estabilidad biomecánica suficiente para obtener los mejores resultados. El objetivo de este trabajo es mostrar los resultados clínicos y radiológicos del tratamiento de las fracturas diafisiarias de tibia con osteosíntesis mínimamente invasiva con placa por cara lateral. Se realizó un estudio clínico observacional, prospectivo, longitudinal y no concurrente. Se incluyeron pacientes mayores de 18 años, de ambos sexos, con diagnósticos de fracturas diafisiarias de tibia 42A, 42B ó 42C, abiertas o cerradas. Se estableció tiempo de seguimiento mínimo de 6 meses. Se incluyeron 23 pacientes, 82,60% de sexo masculino. Promedio de edad de 21±5,63(16­49) años. La fractura más frecuente fue la 42B2 en 26,00% de los casos, y 34,80% fracturas fueron abiertas. A las 12 semanas, 65,10% habían alcanzado consolidación Montoya III; y para la semana 16, 91,30% de los pacientes. De acuerdo a la escala ASAMI, se alcanzaron resultados excelentes en 100,00% pacientes para la semana 16. No se presentaron complicaciones como infección, aflojamiento séptico o aséptico del implante, ni fatiga del mismo. El uso de la técnica MIPO para tratamiento de fracturas diafisiarias de la tibia, por cara lateral es una técnica efectiva y segura, con alta tasas de consolidación, mínimas complicaciones y buenos resultados finales(AU)


Minimally invasive surgical techniques help the natural bone healing process to occur, by providing enough biomechanical stability to obtain the best results. The objective is to show the clinical and radiological results of the treatment of diaphyseal tibial fractures with minimally invasive osteosynthesis with lateral plating. An observational, prospective, longitudinal and non-concurrent clinical study was made. Patients older than 18 years, both sexes, with diagnoses of open or closed tibial shaft fractures 42A, 42B or 42C, were included. A minimum follow-up time of 6 months was established. 23 patients were included, 82,60% male. Average age of 21 years. The most frequent fracture was 42B2 in 26,00% cases, and 34,80% were open fractures. At 12 weeks, 65,10% had reached Montoya III consolidation criterias; and for week 16, 91,30% of the patients. According to the ASAMI scale, excellent results were achieved in 100,00% patients. There were no complications such as infection, septic or aseptic loosening of the implant, or fatigue of the implant. The use of the MIPO technique for the treatment of diaphyseal fractures of the tibia on the lateral aspect is an effective and safe technique, with high rates of union, minimal complications and good final results(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Dispositivos de Fixação Ortopédica , Fraturas da Tíbia , Fixação Interna de Fraturas , Lâmina de Crescimento , Traumatologia , Procedimentos Ortopédicos
3.
Rev. venez. cir. ortop. traumatol ; 53(1): 20-26, jun. 2021. ilus
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1252895

RESUMO

Cuando fracasa el tratamiento conservador en el Estadio I de Disfunción del Tendón Tibial posterior (DTTP), se debe indicar sinovectomía y debridamiento del tendón. En este estudio evaluamos la evolución con 8 años mínimo de seguimiento, de los pacientes con esta patología tratados vía tenoscópica. Este es un estudio retrospectivo de pacientes operados entre el año 2008 y el año 2011. En ese período de tiempo se intervinieron 11 pacientes con esta patología. Sólo 9 de los 11 pacientes operados pudieron ser evaluados. 7 pacientes mejoraron su sintomatología según el VAS y no progresaron a estadio II. En 3 pacientes se evidenció lesión tendinosa durante la tendoscopía y ameritaron reparación a cielo abierto. La sinovectomía tendoscópica del TTP es un procedimiento quirúrgico efectivo para tratar a los pacientes con DTTP Estadio I, rebeldes a tratamiento conservador(AU)


When conservative treatment fails for Stage I Posterior Tibial tendon dysfunction (PTTD), synovectomy and tendon debridement is indicated. In this study we evaluate tendoscopic treatment results for this pathology with a minimum of 8 years follow up. This is a retrospective study of patients after tendoscopic surgery performed between 2008 and 2011. 9 of the 11 patients were available for evaluation. 7 improved their symptoms according to VAS scale, and did not progress to stage II. In 3 patients tendon tear was visualized during tendoscopy and needed open repair. PTT tendoscopy is an effective surgical treatment to treat Stage I PTTD, failing to conservative treatment(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Pé Chato , Espectroscopia de Ressonância Magnética , Anti-Inflamatórios não Esteroides/uso terapêutico , Disfunção do Tendão Tibial Posterior/patologia , Tendinopatia , Sinovectomia , Ultrassom , Crioterapia , Técnicas e Procedimentos Diagnósticos , Desbridamento
4.
Rev. venez. cir. ortop. traumatol ; 53(1): 10-19, jun. 2021. ilus
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1252872

RESUMO

El manejo de pseudoartrosis infectadas, osteomielitis y defectos óseos representa un reto enorme para el cirujano ortopedista. Hace diez años, Masquelet presentó la técnica de inducción de membrana como alternativa al manejo de las complicaciones mencionadas arriba con excelentes tasas de consolidación y erradicación del proceso infeccioso. Estudiamos una de serie de 14 casos, prospectiva, con seguimiento clínico y radiológico mínimo de 2 años (enero 2015-diciembre 2018), donde evaluamos múltiples variables en pacientes a quienes se les realizó el protocolo de Masquelet. Obtuvimos una tasa de consolidación de 85,7% (12/14). Con un tiempo promedio para alcanzarla de 6,1 meses (3-9m). Todos los pacientes que lograron la consolidación se encontraban libres de infección al final del seguimiento. Por su reproducibilidad y alta tasa de consolidación, consideramos la técnica de inducción de membrana, como una excelente opción en el manejo de pseudoartrosis infectadas complejas(AU)


The management of infected nonunions, osteomyelitis, and bone defects represents an enormous challenge for the orthopedic surgeon. Ten years ago, Masquelet presented the membrane induction technique as an alternative to the management of the complications afore mentioned with excellent rates of consolidation and eradication of the infectious process. We prospectively studied a series of 14 cases, with a clinical and radiological follow-up of at least 2 years (january 2015-december 2018). Where we evaluated multiple variables in patients who underwent the Masquelet protocol. We obtained a consolidation rate of 85.7% (12/14). With an average time to reach it of 6.1 months (3-9m). All patients who achieved union were free of infection at the end of follow-up. Due to its reproducibility and high consolidation rate, we consider the membrane induction technique an excellent option in the management of complex infected nonunions(AU)


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Osteomielite/complicações , Pseudoartrose/complicações , Transplante Ósseo , Procedimentos Ortopédicos , Doenças Ósseas , Traumatologia
7.
Artigo em Inglês | MEDLINE | ID: mdl-34062783

RESUMO

The COVID-19 pandemic is a public health emergency of international concern, and the main measures to contain the spread of the coronavirus causing COVID-19 were social distancing, quarantine, and self-isolation. Although these policies are effective in containing the spread of the virus, they might represent a challenge to psychological well-being, increasing levels of depressive and anxiety-related symptoms. AIMS: We explored the frequency of anxiety and depression symptoms during COVID-19 restrictions and associations with sociodemographic factors in a Brazilian sample. METHOD: Data of a total of 936 Brazilian adults (68.2% women) aged 18 to 77 years old (M = 38.95, SD = 13.91) were collected through an online survey. RESULTS: In general, we observed a frequency of 17.36% for severe anxiety and 66.13% for severe depression symptoms, in which younger participants (18-39 years old) and women showed higher scores in anxiety and depression scales compared to older age groups. Logistic regressions showed that women were more likely to present severe symptoms of anxiety (20.4%) compared to men (10.9%), as well as respondents in the educational sector (24.3%) compared to those in the health sector (10%). CONCLUSIONS: We highlight the importance of mental health professionals in developing strategies to help younger adults to mitigate the effects of social restriction.


Assuntos
Pandemias , Adolescente , Adulto , Idoso , Ansiedade/epidemiologia , Brasil/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Surtos de Doenças , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários , Adulto Jovem
8.
Artigo em Inglês | MEDLINE | ID: mdl-34064950

RESUMO

The use of traditional medicinal plants in Saudi Arabia stems mainly from consumers' belief in prophetic medicine. This study was conducted to explore changes in patients' use of dietary or herbal supplements among individuals infected with COVID-19 before and during infection and the association between herbal or dietary supplements and hospitalization. A cross-sectional, questionnaire-based study was conducted enrolling symptomatic patients who had recently recovered from COVID-19. Data were collected through phone interviews, and McNemar's test was used to investigate changes to consumption of dietary or herbal supplements before and during infection. Multivariable logistic regression was used to investigate the association between supplements use during patients' infection and hospitalization. A total of 738 patients were included in this study, of whom 32.1% required hospitalization. About 57% of participants were male with a mean age of 36.5 (±11.9) years. The use of lemon/orange, honey, ginger, vitamin C, and black seed among participants significantly increased during their infection. In contrast, patients using anise, peppermint, and coffee peel before their infection were more likely to stop using them during their infection. In addition, using lemon/orange (p < 0.0001), honey (p = 0.0002), ginger (p = 0.0053), vitamin C (p = 0.0006), black seed (p < 0.0001), peppermint (p = 0.0027), costus (p = 0.0095), and turmeric (p = 0.0012) was significantly higher among nonhospitalized patients than hospitalized ones. However, in the multivariable logistic regression, only use of vitamin C (OR = 0.51; 95% CI 0.33-0.79), peppermint (OR = 0.53; 95% CI 0.31-0.90), and lemon/orange (OR = 0.54; 95% CI 0.33-0.88) was associated with significantly lower odds of hospitalization. The study reveals that patients' consumption of dietary or herbal supplements changed in response to their COVID-19 infection, with hospitalized patients having a lower likelihood of using these supplements. Because some supplements were associated with lower odds of hospitalization, these supplements or their bioactive components should be further investigated as feasible options for COVID-19 treatment.


Assuntos
Adulto , Estudos Transversais , Suplementos Nutricionais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Arábia Saudita/epidemiologia , Adulto Jovem
9.
Artigo em Inglês | MEDLINE | ID: mdl-34064973

RESUMO

Despite older adults' extremely high vulnerability to COVID-19 complications and death, few studies have examined how personal characteristics and the COVID-19 pandemic have impacted the mental health of older adults at the global level. The purpose of this study was to examine the relationships among demographics, COVID-19 life impacts, and depression and anxiety in adults aged 60 and older from 33 countries. A sample of 823 older adults aged 60-94 and residing in 33 countries completed a 10-min online survey following recruitment from mailing lists and social media. Being separated from and having conflicts with loved ones predicted both anxiety and depression, as did residing in a country with higher income. Getting medical treatment for severe symptoms of COVID-19 and having decreased work responsibilities predicted depression, but adjustment to working from home and younger age predicted both depression and anxiety. Participants from Europe and Central Asia reported higher depression than those from all other regions and higher anxiety than those from Latin America and the Caribbean. The COVID-19 pandemic has had serious deleterious effects on the mental health of older adults worldwide. The current findings have direct implications for mental health services that may be delivered to older adults to help facilitate healthy psychological adjustment.


Assuntos
Pandemias , Idoso , Ansiedade/epidemiologia , Região do Caribe , Estudos Transversais , Depressão/epidemiologia , Europa (Continente) , Humanos , Saúde Mental , Pessoa de Meia-Idade
10.
Artigo em Inglês | MEDLINE | ID: mdl-34081044

RESUMO

INTRODUCTION: In response to the SARS-CoV-2 pandemic, physician attire has evolved to incorporate personal protective equipment (PPE). Although PPE is mandated for all healthcare workers, variability exists in choice and availability. The purpose of this study was to determine patient perception of physician attire during the COVID-19 pandemic in an outpatient setting. METHODS: Three hundred sixty-eight patients who presented to our outpatient orthopaedic clinics completed an anonymous survey. In addition to demographic characteristics, patient preferences for attire, PPE, and social distancing were obtained. RESULTS: Scrubs (81%, 298/368) were found to be the most acceptable physician attire. Eye protection (34.2%, 126/368) and gloves (32.6%, 120/368), however, were deemed much less acceptable; 93.5% (344/368) of patients reported that no mask was unacceptable, with 41.0% (151/368) preferring a surgical mask. Predilection for a surgical mask and N95 rose with increasing patient education level. Interestingly, 55.2% (203/368) responded that physicians should stop wearing PPE only when the Center for Disease Control recommends. CONCLUSION: During the COVID-19 pandemic, most of the patients found scrubs to be the most acceptable attire in an office-based outpatient setting. Patients also found physician mask-wearing to be important but are less accepting of providers wearing eye and hand protection.


Assuntos
Assistência Ambulatorial , Atitude Frente a Saúde , COVID-19/prevenção & controle , Vestuário , Dispositivos de Proteção dos Olhos , Luvas Cirúrgicas , Respiradores N95 , Satisfação do Paciente , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Escolaridade , Feminino , Humanos , Masculino , Máscaras , Pessoa de Meia-Idade , Equipamento de Proteção Individual , Roupa de Proteção , SARS-CoV-2 , Inquéritos e Questionários , Adulto Jovem
11.
MMWR Morb Mortal Wkly Rep ; 70(22): 807-810, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34081684

RESUMO

The effect of HIV infection on COVID-19 outcomes is unclear. Studies in South Africa (1) and the United Kingdom (2) found an independent association between HIV infection and COVID-19 mortality; however, other studies have not found an association between poor COVID-19 outcomes and either HIV status among hospitalized patients (3-5) or HIV-associated factors such as CD4 count, viral load, or type of antiretroviral therapy (ART) (6). The effect of HIV infection on COVID-19 outcomes remains an urgent question in sub-Saharan Africa, where many countries are experiencing dual HIV and COVID-19 epidemics, and capacity to treat severe COVID-19 is limited. Using data from patients with probable or confirmed COVID-19 admitted to specialized treatment centers during March-December 2020 in Zambia, the Zambian Ministry of Health and CDC assessed the relationship between HIV infection and severe COVID-19 and COVID-19-associated death. Among 443 patients included in the study, 122 (28%) were HIV-positive, and of these, 91 (89%) were receiving ART at the time of hospitalization. HIV status alone was not significantly associated with severe COVID-19 at admission or during hospitalization or with COVID-19-associated death. However, among HIV-positive persons, those with severe HIV disease were more likely to develop severe COVID-19 and were at increased risk for COVID-19-associated death. Ensuring that persons maintain HIV disease control, including maintaining ART continuity and adherence, achieving viral suppression, and addressing and managing underlying medical conditions, could help reduce COVID-19-associated morbidity and mortality in sub-Saharan Africa.


Assuntos
COVID-19/mortalidade , COVID-19/terapia , Infecções por HIV/epidemiologia , Índice de Gravidade de Doença , Adolescente , Adulto , Feminino , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem , Zâmbia/epidemiologia
12.
J Aging Stud ; 57: 100929, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34082999

RESUMO

Early reports of COVID-19 often inaccurately presented the virus as a serious concern only among older adults. On the social media platform of Twitter, #BoomerRemover originated as a hashtag intended to express the age-related disparities of COVID-19. This study used a content analysis to examine tweets over a two-week period in March 2020 that used #BoomerRemover to discuss COVID-19 among older adults. A total of 1875 tweets were analyzed. Salient themes include: (1) There's a Real Intergenerational Divide, (2) Young People are Affected Too, (3) It's Being Used for Political Gain, and (4) #BoomerRemover is Simply Disrespectful. Findings suggest that many of the tweets employing #BoomerRemover were grounded in either personal or political ageism. In addition, a significant portion of tweeters used #BoomerRemover to defend older adults and speak out against ageism. This study highlights the importance of recognizing and addressing the growing intergenerational divide on social media, particularly during the COVID-19 pandemic.


Assuntos
Ageismo/psicologia , Ageismo/estatística & dados numéricos , COVID-19/psicologia , Mídias Sociais/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Idoso , Humanos , Pessoa de Meia-Idade , SARS-CoV-2 , Adulto Jovem
13.
J Aging Stud ; 57: 100932, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34083001

RESUMO

Adoption of strict social distancing and sanitary measures were inevitable in the attempt to thwart the spread of the Covid-19 virus. These measures, however, came at a cost for older adults who faced major mental health issues because of social isolation. The impact of social isolation remains well documented in the wake of the pandemic. This paper explored the lived experiences of older adults living in the community during the Covid-19 sanitary lockdown in the small-island state of Mauritius. As a small-island state with family structures that still skew towards extended or modified extended families, it was interesting to explore whether older adults would be reporting feelings of social isolation as was being reported elsewhere. This study utilized a qualitative approach using a lifeworld hermeneutical approach with 15 older adult participants, recruited through convenience and snowball sampling, in the community. Data were collected using a narrative approach supplemented by an interview guide. Thematic analysis was used to identify themes from transcribed and translated data. Six themes were discovered: Fears of the virus and fear of deprivation; Reliving and recreating bonds; Active contribution to family life; Being and feeling valued within the family; Rediscovering family time and family moments; and Fear of going back to 'normal'. The study revealed positive experiences of the lockdown period characterised by an increase bonding in the family, deepening of familial bond, and increased value despite an initial apprehension of the lockdown. A renewed sense of purpose as well as deepening of bonds was reported by older adults. Some limitations in relation to data trustworthiness and respondents bias, however, could not be avoided since the study was carried out during sanitary lockdown period. The feelings of social isolation and depression reported by older adults who lived alone were not seen in this study, suggesting that the family structure may have a role to play in mitigating these effects. There would also be a need to explore similar small-island states or similar cultures where the effects of sanitary lockdowns may be different from current literature.


Assuntos
COVID-19/psicologia , Família/psicologia , Medo/psicologia , Distanciamento Físico , Isolamento Social/psicologia , Idoso , COVID-19/prevenção & controle , Feminino , Humanos , Vida Independente , Masculino , Maurício , Pessoa de Meia-Idade , SARS-CoV-2
14.
PLoS One ; 16(6): e0252427, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34086706

RESUMO

INTRODUCTION: COVID-19 is primarily a respiratory illness, and smoking adversely impacts the respiratory and immune systems; this confluence may therefore incentivize smokers to quit. The present study, conducted in four high-income countries during the first global wave of COVID-19, examined the association between COVID-19 and: (1) thoughts about quitting smoking; (2) changes in smoking (quit attempt, reduced or increased smoking, or no change); and (3) factors related to a positive change (making a quit attempt or reducing smoking) based on an adapted framework of the Health Belief Model. METHODS: This cross-sectional study included 6870 adult smokers participating in the Wave 3 (2020) ITC Four Country Smoking and Vaping Survey conducted in Australia, Canada, England, and United States (US). These four countries had varying responses to the pandemic by governments and public health, ranging from advising voluntary social distancing to implementing national and subnational staged lockdowns. Considering these varying responses, and the differences in the number of confirmed cases and deaths (greatest in England and the US and lowest in Australia), smoking behaviours related to COVID-19 may have differed between countries. Other factors that may be related to changes in smoking because of COVID-19 were also explored (e.g., sociodemographics, nicotine dependence, perceptions about personal and general risks of smoking on COVID-19). Regression analyses were conducted on weighted data. RESULTS: Overall, 46.7% of smokers reported thinking about quitting because of COVID-19, which differed by country (p<0.001): England highest (50.9%) and Australia lowest (37.6%). Thinking about quitting smoking because of COVID-19 was more frequent among: females, ethnic minorities, those with financial stress, current vapers, less dependent smokers (non-daily and fewer cigarettes smoked/day), those with greater concern about personal susceptibility of infection, and those who believe COVID-19 is more severe for smokers. Smoking behaviour changes due to COVID-19 were: 1.1% attempted to quit, 14.2% reduced smoking, and 14.6% increased smoking (70.2% reported no change). Positive behaviour change (tried to quit/reduced smoking) was reported by 15.5% of smokers, which differed by country (p = 0.02), where Australia had significantly lower rates than the other three countries. A positive behavioural smoking change was more likely among smokers with: lower dependence, greater concern about personal susceptibility to infection, and believing that COVID-19 is more severe for smokers. CONCLUSIONS: Though nearly half of smokers reported thinking about quitting because of COVID-19, the vast majority did not change their smoking behaviour. Smokers were more likely to try and quit or reduce their smoking if they had greater concern about susceptibility and severity of COVID-19 related to smoking. Smokers in Australia were least likely to reduce or try to quit smoking, which could be related to the significantly lower impact of COVID-19 during the early phase of the pandemic relative to the other countries.


Assuntos
COVID-19/epidemiologia , Cognição , Comportamentos Relacionados com a Saúde , SARS-CoV-2 , Fumantes , Abandono do Hábito de Fumar , Inquéritos e Questionários , Fumar Tabaco/epidemiologia , Vaping/epidemiologia , Adolescente , Adulto , COVID-19/psicologia , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Fumar Tabaco/psicologia , Vaping/psicologia
15.
PLoS One ; 16(6): e0252347, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34086717

RESUMO

BACKGROUND: Dysphagia appears to be common in patients with severe COVID-19. Information about the characteristics of dysphagia and laryngeal findings in COVID-19 patients treated in the intensive care unit (ICU) is still limited. OBJECTIVES: The aim of this study was to evaluate oropharyngeal swallowing function and laryngeal appearance and function in patients with severe COVID-19. METHOD: A series of 25 ICU patients with COVID-19 and signs of dysphagia were examined with fiberendoscopic evaluation of swallowing (FEES) during the latter stage of ICU care or after discharge from the ICU. Swallowing function and laryngeal findings were assessed with standard rating scales from video recordings. RESULTS: Pooling of secretions was found in 92% of patients. Eleven patients (44%) showed signs of silent aspiration to the trachea on at least one occasion. All patients showed residue after swallowing to some degree both in the vallecula and hypopharynx. Seventy-six percent of patients had impaired vocal cord movement. Erythema of the vocal folds was found in 60% of patients and edema in the arytenoid region in 60%. CONCLUSION: Impairment of oropharyngeal swallowing function and abnormal laryngeal findings were common in this series of patients with severe COVID-19 treated in the ICU. To avoid complications related to dysphagia in this patient group, it seems to be of great importance to evaluate the swallowing function as a standard procedure, preferably at an early stage, before initiation of oral intake. Fiberendoscopic evaluation of swallowing is preferred due to the high incidence of pooling of secretion in the hypopharynx, silent aspiration, and residuals. Further studies of the impact on swallowing function in short- and long-term in patients with COVID-19 are warranted.


Assuntos
COVID-19 , Transtornos de Deglutição , Deglutição , Unidades de Terapia Intensiva , Laringe , SARS-CoV-2 , Adulto , Idoso , COVID-19/complicações , COVID-19/patologia , COVID-19/fisiopatologia , COVID-19/terapia , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/patologia , Transtornos de Deglutição/fisiopatologia , Feminino , Humanos , Laringe/patologia , Laringe/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença
16.
PLoS One ; 16(6): e0252189, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34086722

RESUMO

BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic has had a great impact on every aspect of society. All countries launched preventive measures such as quarantine, lockdown, and physical distancing to control the disease spread. These restrictions might effect on daily life and mental health. This study aimed to assess the prevalence and associated factors of depressive symptoms in patients with COVID-19 at the Treatment Center. METHODS: A cross-sectional telephone survey was carried out at Hmawbi COVID-19 Treatment Center, Myanmar from December 2020 to January 2021. A total of 142 patients with COVID-19 who met the criteria were invited to participate in the study. A pre-tested Center for Epidemiologic Studies Depression Scale (CES-D) was used as a tool for depressive symptoms assessment. Data were analyzed by using binary logistic regression to identify associated factors of depressive symptoms. Adjusted odds ratio (AOR) with a 95% confidence interval (CI) was computed to determine the level of significance with a p < 0.05. RESULTS: The prevalence of depressive symptoms in patients with COVID-19 was 38.7%, with the means (± standard deviation, SD) subscale of somatic symptom, negative effect, and anhedonia were 4.64 (±2.53), 2.51 (± 2.12), and 5.01 (± 3.26), respectively. The patients with 40 years and older (AOR: 2.99, 95% CI: 1.36-6.59), < 4 of household size (AOR: 3.45, 95% CI: 1.46-8.15), ≤ 400,000 kyats of monthly family income (AOR: 2.38, 95% CI: 1.02-5.54) and infection to family members (AOR: 4.18, 95% CI: 1.74-10.07) were significant associated factors of depressive symptoms. CONCLUSION: The high prevalence of depressive symptoms, approximately 40%, was found in patients with COVID-19 in the Treatment Center. Establishments of psychosocial supports, providing psychoeducation, enhancing the social contact with family and friends, and using credible source of information related COVID-19 would be integral parts of mental health services in COVID-19 pandemic situation.


Assuntos
COVID-19 , Depressão , Epidemias , SARS-CoV-2 , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/complicações , COVID-19/epidemiologia , COVID-19/terapia , Estudos Transversais , Depressão/epidemiologia , Depressão/etiologia , Depressão/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mianmar/epidemiologia , Prevalência
17.
PLoS One ; 16(6): e0252326, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34086727

RESUMO

BACKGROUND: COVID-19 has exerted a variety of impacts on people, particularly people with limited education living in poor economic settings. This study investigates the impacts of and adaptations to COVID-19 among the hill tribe people of northern Thailand. METHODS: A qualitative method was used to elicit information from key informants who lived in a hill tribe village in Mae Fah Laung district, Chiang Rai Province, Thailand. Fourteen questions on two issues were used to gather information, and an NVivo program was used to extract the findings. RESULTS: A total of 57 hill tribe villagers participated, including 36 females and 21 males (mean age of 50.1 years, min = 20 and max = 90). Twenty-seven individuals were Thai Yai, 14 were Yunan Chinese, eight were Akha, and eight were members of other minor tribes. Regarding education and occupation, 30 individuals were illiterate, while 27 had attended different levels of primary school; 40 individuals were unemployed, 13 were employed as daily wage workers and farmers, and the other 4 were attending school. Three age categories were used to assess the impacts of the COVID-19 pandemic: impact of access to the educational system among the young, loss of jobs and family financial problems among the working, and access to medical care for the elderly. Six adaptation stages in response to the COVID-19 crisis were observed among the hill tribe people: shock stage with no prior experience, looking for help from health and other agencies, considering the national lockdown policy, complying with prevention and control measures, reducing stressful situations and following the new normal approach, and addressing suffering points at home and elsewhere. CONCLUSIONS: The COVID-19 pandemic has exerted different impacts on different age categories among the hill tribe population living in remote and border areas. Effective adaptations have been implemented to address the new normal life under the disease, and six adaptation stages have been identified that have helped them survive the greatest threat to humankind today.


Assuntos
Adaptação Psicológica , COVID-19 , Pandemias , Grupos Populacionais , SARS-CoV-2 , Adulto , Idoso , Idoso de 80 Anos ou mais , COVID-19/etnologia , COVID-19/mortalidade , COVID-19/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tailândia/epidemiologia , Tailândia/etnologia
18.
PLoS One ; 16(6): e0252603, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34086747

RESUMO

BACKGROUND: In the fight against the COVID-19 pandemic, frontline healthcare providers who are engaged in the direct diagnosis, treatment, and care of patients face a high risk of infection yet receive inadequate protection from contamination and minimal support to cope with overwork, frustration, and exhaustion. These problems have created significant psychological and mental health concerns for frontline healthcare providers. This study aimed to compare the levels of vicarious traumatization between frontline and non-frontline healthcare providers in response to the COVID-19 pandemic. METHODOLOGY: All the subjects who met the inclusion criteria were recruited for this comparative cross-sectional study, which was conducted from May to July 2020 in two hospitals in Kelantan, Malaysia. A self-administered questionnaire, namely, the Malay-version Vicarious Traumatization Questionnaire and the Medical Outcome Study Social Support Survey were utilized. A descriptive analysis, independent t-test, and analysis of covariance were performed using SPSS Statistics version 26. RESULTS: A total of 160 frontline and 146 non-frontline healthcare providers were recruited. Vicarious traumatization was significantly higher among the non-frontline healthcare providers (estimated marginal mean [95% CI]: 79.7 [75.12, 84.30]) compared to the frontline healthcare providers (estimated marginal mean [95% CI]: 74.3 [68.26, 80.37]) after adjusting for sex, duration of employment, and social support. CONCLUSION: The level of vicarious traumatization was higher among non-frontline compared to frontline healthcare providers. However, the level of severity may differ from person to person, depending on how they handle their physical, psychological, and mental health. Hence, support from various resources, such as colleagues, family, the general public, and the government, may play an essential role in the mental health of healthcare providers.


Assuntos
COVID-19 , Fadiga por Compaixão , Pessoal de Saúde , Saúde Mental , Pandemias , Trauma Psicológico , SARS-CoV-2 , Inquéritos e Questionários , Adulto , COVID-19/epidemiologia , COVID-19/psicologia , Fadiga por Compaixão/epidemiologia , Fadiga por Compaixão/psicologia , Feminino , Humanos , Malásia/epidemiologia , Masculino , Pessoa de Meia-Idade , Trauma Psicológico/epidemiologia , Trauma Psicológico/psicologia
19.
PLoS One ; 16(6): e0252454, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34086762

RESUMO

BACKGROUND: Though SARS-CoV-2 outbreaks have been documented in occupational settings and in-person essential work has been suspected as a risk factor for COVID-19, occupational differences in excess mortality have, to date, not been examined. Such information could point to opportunities for intervention, such as vaccine prioritization or regulations to enforce safer work environments. METHODS AND FINDINGS: Using autoregressive integrated moving average models and California Department of Public Health data representing 356,188 decedents 18-65 years of age who died between January 1, 2016 and November 30, 2020, we estimated pandemic-related excess mortality by occupational sector and occupation, with additional stratification of the sector analysis by race/ethnicity. During these first 9 months of the COVID-19 pandemic, working-age adults experienced 11,628 more deaths than expected, corresponding to 22% relative excess and 46 excess deaths per 100,000 living individuals. Sectors with the highest relative and per-capita excess mortality were food/agriculture (39% relative excess; 75 excess deaths per 100,000), transportation/logistics (31%; 91 per 100,000), manufacturing (24%; 61 per 100,000), and facilities (23%; 83 per 100,000). Across racial and ethnic groups, Latino working-age Californians experienced the highest relative excess mortality (37%) with the highest excess mortality among Latino workers in food and agriculture (59%; 97 per 100,000). Black working-age Californians had the highest per-capita excess mortality (110 per 100,000), with relative excess mortality highest among transportation/logistics workers (36%). Asian working-age Californians had lower excess mortality overall, but notable relative excess mortality among health/emergency workers (37%), while White Californians had high per-capita excess deaths among facilities workers (70 per 100,000). CONCLUSIONS: Certain occupational sectors are associated with high excess mortality during the pandemic, particularly among racial and ethnic groups also disproportionately affected by COVID-19. In-person essential work is a likely venue of transmission of coronavirus infection and must be addressed through vaccination and strict enforcement of health orders in workplace settings.


Assuntos
COVID-19 , Grupos de Populações Continentais , Grupos Étnicos , Ocupações , Pandemias , SARS-CoV-2 , Adolescente , Adulto , Idoso , COVID-19/etnologia , COVID-19/mortalidade , California/epidemiologia , California/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
20.
PLoS One ; 16(6): e0252679, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34086775

RESUMO

INTRODUCTION: End-stage kidney disease (ESKD) patients are at a high risk for Coronavirus Disease 2019 (COVID-19). In this study, we compared characteristics and outcomes of ESKD and non-ESKD patients admitted with COVID-19 to a large safety-net hospital. METHODS: We evaluated 759 adults (45 with ESKD) hospitalized with COVID-19 in Spring of 2020. We examined clinical characteristics, laboratory measures and clinical outcomes. Logistic regression analyses were performed to investigate the associations between ESKD status and outcomes. RESULTS: 73% of ESKD and 47% of non-ESKD patients identified as Black (p = 0.002). ESKD patients were older and had higher rates of comorbidities. Admission ferritin was approximately 6-fold higher in ESKD patients. During hospitalization, the rise in white blood cell count, lactate dehydrogenase, ferritin and C-reactive protein, and the decrease in platelet count and serum albumin were all significantly greater in ESKD patients. The in-hospital mortality was higher for ESKD [18% vs. 10%; multivariable adjusted odds ratio 1.5 (95% CI, 0.48-4.70)], but this did not reach statistical significance. CONCLUSIONS: Among hospitalized COVID-19 patients, ESKD patients had more co-morbidities and more robust inflammatory response than non-ESKD patients. The odds ratio point estimate for death was higher in ESKD patients, but the difference did not reach statistical significance.


Assuntos
COVID-19/mortalidade , Mortalidade Hospitalar , Hospitais Urbanos , Falência Renal Crônica/mortalidade , SARS-CoV-2 , Segurança , Adulto , Idoso , Boston/epidemiologia , COVID-19/sangue , Comorbidade , Feminino , Humanos , Falência Renal Crônica/sangue , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
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