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2.
Mayo Clin Proc ; 96(4): 912-920, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33714601

RESUMO

OBJECTIVE: To assess the prevalence and characteristics of coronavirus disease 2019 (COVID-19) cases during the reopening period in older adults, given that little is known about the prevalence of COVID-19 after the stay-at-home order was lifted in the United States, nor the actual effects of adherence to recommended public health measures (RPHM) on the risk of COVID-19. PATIENTS AND METHODS: This was a cross-sectional study nested in a parent prospective cohort study, which followed a population-based sample of 2325 adults 50 years and older residing in southeast Minnesota to assess the incidence of viral infections. Participants were instructed to self-collect both nasal and oropharyngeal swabs, which were tested by reverse transcription polymerase chain reaction-based severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) assay between May 8, 2020, and June, 30, 2020. We assessed the prevalence of COVID-19 cases and characteristics of study subjects. RESULTS: A total of 1505 eligible subjects participated in the study whose mean age was 68 years, with 885 (59%) women, 32 (2%) racial/ethnic minorities, and 906 (60%) with high-risk conditions for influenza. The prevalence of other Coronaviridae (human coronavirus [HCoV]-229E, HCoV-NL63, and HCoV-OC43) during the 2019 to 2020 flu season was 109 (7%), and none tested positive for SARS-CoV-2. Almost all participants reported adhering to the RPHM (1,488 [99%] for social distancing, 1,438 [96%] for wearing mask in a public space, 1,476 [98%] for hand hygiene, and 1,441 (96%) for staying home mostly). Eighty-six percent of participants resided in a single-family home. CONCLUSION: We did not identify SARS-COV-2 infection in our study cohort. The combination of participants' behavior in following the RPHM and their living environment may considerably mitigate the risk of COVID-19.


Assuntos
Controle de Doenças Transmissíveis , Fidelidade a Diretrizes/estatística & dados numéricos , Saúde Pública , Idoso , /epidemiologia , /psicologia , /estatística & dados numéricos , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Controle de Doenças Transmissíveis/estatística & dados numéricos , Estudos Transversais , Transmissão de Doença Infecciosa/prevenção & controle , Feminino , Humanos , Masculino , Minnesota/epidemiologia , Prevalência , Saúde Pública/métodos , Saúde Pública/estatística & dados numéricos , Comportamento de Redução do Risco , Precauções Universais/métodos , Precauções Universais/estatística & dados numéricos , Virologia/métodos
3.
Emerg Infect Dis ; 27(2): 404-410, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33395382

RESUMO

Switzerland began a national lockdown on March 16, 2020, in response to the rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We assessed the prevalence of SARS-CoV-2 infection among patients admitted to 4 hospitals in the canton of Zurich, Switzerland, in April 2020. These 4 acute care hospitals screened 2,807 patients, including 2,278 (81.2%) who did not have symptoms of coronavirus disease (COVID-19). Overall, 529 (18.8%) persons had >1 symptom of COVID-19, of whom 60 (11.3%) tested positive for SARS-CoV-2. Eight asymptomatic persons (0.4%) also tested positive for SARS-CoV-2. Our findings indicate that screening on the basis of COVID-19 symptoms, regardless of clinical suspicion, can identify most SARS-CoV-2-positive persons in a low-prevalence setting.


Assuntos
/estatística & dados numéricos , Testes Diagnósticos de Rotina/estatística & dados numéricos , Admissão do Paciente/estatística & dados numéricos , Precauções Universais/estatística & dados numéricos , Adulto , Idoso , /prevenção & controle , Testes Diagnósticos de Rotina/métodos , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Suíça/epidemiologia , Precauções Universais/métodos
4.
Rev. senol. patol. mamar. (Ed. impr.) ; 33(4): 130-136, oct.-dic. 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-192959

RESUMO

OBJETIVO: Describir las medidas adoptadas dentro del plan de contingencia del COVID-19 respecto a la biopsia selectiva de ganglio centinela (BSGC) y analizar su impacto sobre la actividad asistencial. METODOLOGÍA: Estudio cualitativo, descriptivo y retrospectivo de BSGC realizadas durante el período del 14/03 al 11/05 de 2020. Análisis de las medidas tomadas para minimizar las probabilidades de contagio y resultados de PCR de pacientes y personal. Comparativa de casos con los realizados en el mismo período de 2019. Actividad diaria de linfogammagrafía y de cirugía radioguiada (CRG) por indicación médica. Cálculo numérico y porcentual de CRG por hospital y recursos humanos diarios de medicina nuclear requeridos. RESULTADOS: Se realizaron 42 intervenciones con BSGC, un 31,1% menos que en 2019. La indicación médica de cáncer de mama experimentó el mayor descenso de actividad (n=18, 41,9%). Del total de CRG, Hospital Clínic realizó el 45,2%, Hospital Maternitat el 31,0%, Hospital Plató el 16,7% y Hospital Sant Joan de Déu el 7,1% restante. En relación con los recursos humanos, la planificación inicial se cumplió en un 77% de los días. El total de los controles PCR a pacientes (n=42) y personal de CRG (n=9) dio resultado negativo. CONCLUSIONES: El COVID-19 influyó negativamente en la actividad asistencial de la BSGC del Hospital Clínic, pero fue compensado por una planificación acertada, basada en el análisis previo de los procesos del procedimiento, que permitió adaptar los recursos de material y personal a las circunstancias cambiantes, otorgándole una flexibilidad que posibilitó el cumplimiento de la programación establecida


OBJECTIVE: To describe the measures taken within the COVID-19 contingency plan concerning sentinel lymph node biopsy (SNB) procedures and to assess their impact on healthcare activity. METHODOLOGY: Qualitative, descriptive and retrospective study of SNB procedures conducted during the lockdown period of COVID-19 (14/03 to 11/05 2020). Analysis of measures taken to minimise the chances of contagion and PCR outcomes of patients and staff. Comparison with SNB procedures conducted in the same time interval in 2019. Daily activity of lymphoscintigraphy and radioguided surgery (RGS) by medical indication. Numerical and percentage calculation of RGS by hospital and daily requirements for human resources in nuclear medicine. RESULTS: Forty-two SNB were performed, representing 31.1% less than those conducted in the same period in 2019. The medical indication of breast cancer showed the greatest activity decrease (n=18, 41.9%). RGS was performed in 45.2% of patients in Hospital Clínic, 31.0% in Maternitat, 16.7% in Plató and 7.1% in Sant Joan de Déu Hospital. Concerning the human resources required, the initial planning was accomplished in 77% of the days (24/31). All the PCR samples from patients (n=42) and RGS staff (n=9) were negative for COVID-19. CONCLUSIONS: COVID-19 negatively influenced the healthcare activity of SNB in Hospital Clínic, but was compensated by adequate planning, based on prior analysis of the procedure's processes, which allowed adaptation of material and personnel resources to the changing circumstances. This allowed flexibility, which in turn enabled compliance with the established schedule


Assuntos
Humanos , Neoplasias da Mama/patologia , Biópsia de Linfonodo Sentinela/estatística & dados numéricos , Infecções por Coronavirus/prevenção & controle , Reação em Cadeia da Polimerase/estatística & dados numéricos , Cirurgia Assistida por Computador/estatística & dados numéricos , Linfocintigrafia/estatística & dados numéricos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Precauções Universais/métodos , Pandemias/estatística & dados numéricos , Biópsia de Linfonodo Sentinela/métodos , Estudos Retrospectivos , Serviço Hospitalar de Medicina Nuclear/estatística & dados numéricos , Gestão da Segurança/métodos
5.
Rev. esp. med. nucl. imagen mol. (Ed. impr.) ; 39(6): 375-379, nov.-dic. 2020. ilus, graf
Artigo em Espanhol | IBECS | ID: ibc-194659

RESUMO

En esta publicación se presentan criterios y fundamentos para la organización del trabajo en la práctica segura de la Radiofarmacia Hospitalaria, a fin de minimizar el riesgo de transmisión viral durante la pandemia de COVID-19, en una instalación de referencia de la Comisión Nacional de Energía Atómica de Argentina, mientras se continúan desempeñando servicios esenciales para el sistema de salud. Con este fin se consultaron como referencia documentos de la Comisión Nacional de Energía Atómica, OIEA, la OMS y otras publicaciones científicas. Estas recomendaciones se encuentran en proceso de revisión constante y son actualizadas de manera permanente. En este marco se propone el presente modelo de organización laboral para esta actividad esencial incluyendo recomendaciones generales, particulares y su fundamento epidemiológico e inmunológico


This publication presents criteria and bases for the work organization in the safe practice of Hospital Radiopharmacy, in order to minimize the risk of viral transmission during the COVID-19 pandemic, in a reference facility of the National Energy Commission Atomic of Argentina, while continuing to perform essential services for the health system. For this purpose, documents from the National Energy Commission Atomic, IAEA, WHO and other scientific publications were consulted as reference. These recommendations are under constant review and are permanently updated. Within this framework, the present model of work organization for this essential activity is proposed, including general and specific recommendations and its epidemiological and immunological basis


Assuntos
Humanos , Vírus da SARS/patogenicidade , Infecções por Coronavirus/epidemiologia , Compostos Radiofarmacêuticos/provisão & distribuição , Assistência Farmacêutica/organização & administração , Fatores de Risco , Infecções por Coronavirus/prevenção & controle , Pandemias/estatística & dados numéricos , Argentina/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Precauções Universais/métodos , Boas Práticas de Dispensação
6.
Rev. andal. med. deporte ; 13(4): 257-260, dic. 2020.
Artigo em Espanhol | IBECS | ID: ibc-195074

RESUMO

La actual situación de pandemia producida por el SARS-CoV-2, obliga a los laboratorios de fisiología del ejercicio a tomar una serie de medidas adicionales para la realización segura de las pruebas de esfuerzo, tanto diagnósticas como de rendimiento. El objetivo del presente trabajo es exponer las medidas a adoptar, para la prevención del contagio por el SARS-CoV-2, durante la realización de pruebas de esfuerzo a deportistas, propuestas por los profesionales del Centro Andaluz de Medicina del Deporte, basadas en la evidencia científica disponible, y que están orientadas hacia su aplicación en el propio laboratorio, a los atletas y a todos los profesionales que participan en su evaluación


The current pandemic situation, produced by SARS-CoV-2, forces exercise physiology laboratories to take a series of additional measures for the safe performance of stress tests, both diagnostic and performance. The objective of this report is to present preventive measures to be taken to avoid contagion by SARS-CoV-2 during exercise tests on athletes, proposed by the professionals of the Andalusian Center for Sports Medicine, based on scientific evidence available, and oriented towards its application in the laboratory itself, to athletes and to all professionals who participate in its evaluation


A atual situação de pandemia produzida pelo SARS-CoV-2 obriga os laboratórios de fisiologia do exercício a tomar uma série de medidas adicionais para a realização segura dos testes de esforço, tanto de diagnóstico quanto de desempenho. O objetivo deste trabalho é apresentar as medidas a serem adotadas para a prevenção do contágio pelo SARS-CoV-2 durante testes de exercício em atletas, propostas pelos profissionais do Centro Andaluz de Medicina do Esporte, com base em evidências científicas disponíveis, e que são orientados para a sua aplicação no próprio laboratório, aos atletas e a todos os profissionais que participam na sua avaliação


Assuntos
Humanos , Infecções por Coronavirus/prevenção & controle , Teste de Esforço/métodos , Gasometria/métodos , Atletas/estatística & dados numéricos , Desempenho Atlético/fisiologia , Controle de Doenças Transmissíveis/organização & administração , Pandemias , Quarentena , Distância Psicológica , Esportes/fisiologia , Precauções Universais/métodos
7.
Rev. esp. anestesiol. reanim ; 67(9): 487-495, nov. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194385

RESUMO

INTRODUCCIÓN: La pandemia actual de SARS-CoV-2 ha supuesto la mayor crisis sociosanitaria mundial experimentada en el último siglo. Cada centro asistencial se ha visto impelido a adecuar las guías de tratamiento establecidas por las distintas sociedades científicas. OBJETIVOS: Analizar el impacto de la metodología basada en la simulación como herramienta de mejora de nuestra práctica clínica: dinámica de trabajo, efectividad y seguridad de todos los facultativos implicados en el manejo del parto en gestantes COVID y su utilidad para facilitar la adecuación de los protocolos a un contexto clínico específico. MÉTODO: Estudio observacional descriptivo que incluye las cesáreas y partos de gestante COVID realizados en nuestro hospital. Se analizaron de manera multidisciplinar las actuaciones ejecutadas utilizando las herramientas de la simulación briefing y debriefing, antes y después de cada caso. RESULTADOS: Se analizaron un total de 5 casos clínicos. Se encontraron dificultades en la ejecución de los protocolos establecidos para la atención de la gestante COVID a nivel organizativo, estructural, de recursos materiales y de factores humanos. CONCLUSIONES: Este modelo de análisis ha resultado una herramienta de gran valor en tres aspectos: la mejora del trabajo en equipo, la realización de protocolos de actuación consensuados y el establecimiento de propuestas efectivas para la adecuación de los protocolos


INTRODUCTION: The current SARS-CoV-2 pandemic has been the world's largest socio-health crisis experienced in the last century. Each healthcare center has been compelled to adapt the treatment guidelines established by the different scientific societies. OBJECTIVES: Analyze the impact of the methodology based on simulation as a tool to improve our clinical practice: work dynamics, effectiveness and safety of all the physicians involved in the management of labor in COVID pregnant women and its usefulness to facilitate the adaptation of protocols to a specific clinical context. METHOD: Descriptive observational study that includes the C-sections and deliveries of COVID pregnant women performed in our hospital. The actions carried out in each procedure were analyzed using the simulation multidisciplinary briefing and debriefing tools, before and after each case. RESULTS: A total of 5 clinical cases were analyzed. Difficulties were found in the execution of the protocols established for the care of the COVID pregnant. Organizational, structural, material resources and human factors obstacles were the most common. CONCLUSIONS: Our results showed that the analysis example using simulation methodology was a tool of great value in three aspects: teamwork improvement, actions consent and improvement proposals for the adaptation and implementation of protocols


Assuntos
Humanos , Infecções por Coronavirus/prevenção & controle , Vírus da SARS/patogenicidade , Complicações Infecciosas na Gravidez/prevenção & controle , Pandemias , Parto Obstétrico/normas , Cesárea/normas , Exercício de Simulação , Precauções Universais/métodos , Infecções por Coronavirus/complicações , Fatores de Risco , Complicações Infecciosas na Gravidez/virologia , Reação em Cadeia da Polimerase Via Transcriptase Reversa
11.
Rev. esp. anestesiol. reanim ; 67(8): 438-445, oct. 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-193564

RESUMO

La infección por COVID-19 afecta también a las pacientes obstétricas. La atención obstétrica habitual ha continuado a pesar de la pandemia. Existen series de casos de pacientes obstétricas. Parece que las técnicas neuroaxiales son seguras y es importante asegurarse que los bloqueos funcionen correctamente antes de una cesárea. Es por esto que se recomienda que los bloqueos sean realizados por anestesiólogos expertos. La protección y seguridad de los profesionales es un punto fundamental y, en caso de anestesia general, también se recomienda acudir al anestesiólogo más experto. Las pacientes gravemente enfermas deben reconocerse rápida y precozmente, para poder suministrarles el tratamiento adecuado lo antes posible. La susceptibilidad a las trombosis hace que la anticoagulación profiláctica sea prioritaria


COVID-19 infection also affects obstetric patients. Regular obstetric care has continued despite the pandemic. Case series of obstetric patients have been published. Neuroaxial techniques appear to be safe and it is important to obtain the highest possible rate of success of the blocks before a cesarean section. For this reason, it is recommended that the blocks be carried out by senior anesthesiologists. The protection and safety of professionals is a key point and in case of general anesthesia, so it is also recommended to call to the most expert anesthesiologist. Seriously ill patients should be recognized quickly and early, in order to provide them with the appropriate treatment as soon as possible. Susceptibility to thrombosis makes prophylactic anticoagulation a priority


Assuntos
Humanos , Infecções por Coronavirus/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Vírus da SARS/patogenicidade , Anestesia Obstétrica/métodos , Cesárea/métodos , Gestantes , Pandemias , Complicações Infecciosas na Gravidez/epidemiologia , Complicações do Trabalho de Parto/epidemiologia , Precauções Universais/métodos
13.
Rev. esp. anestesiol. reanim ; 67(8): 417-424, oct. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-192477

RESUMO

ANTECEDENTES Y OBJETIVO: Durante la pandemia de COVID-19 se produce una reducción del material para la protección de los profesionales. La impresión 3D ofrece la posibilidad de compensar la escasez de algunos de los suministros. El objetivo es describir el papel de la impresión 3D en un servicio de salud durante la pandemia de COVID-19, con énfasis en proceso para desarrollar un producto final listo para ser implementado en el entorno clínico. MATERIALES Y MÉTODOS: Se formó un grupo de trabajo entre la administración sanitaria, clínicos y otras instituciones público-privadas de Cantabria coordinado en el Hospital virtual Valdecilla. El proceso incluyó la recepción de las propuestas de impresión, el conocimiento de los recursos de impresión en la región, la selección de los dispositivos, la creación de un equipo para cada proyecto, diseño de prototipos, evaluación y rediseño, fabricación montaje y distribución. RESULTADOS: Se producen 1) dispositivos que ayudan a prevenir el contagio de los profesionales: pantallas de protección facial (2.400 unidades), accesorios personalizados para fotóforos (20 unidades) y horquillas salvaorejas para mascarillas (1.200 unidades); 2) productos relacionados con la ventilación de pacientes infectados: conectores de sistemas de ventilación no invasiva entre tubuladura y mascarilla; y 3) hisopos oro y nasofaríngeos (7.500 unidades) para la identificación de portadoras del coronavirus con el objetivo de diseñar protocolos de actuación en las área clínicas. CONCLUSIONES: La impresión 3D es un recurso válido para la producción de material de protección de los profesionales cuyo suministro está reducido durante una pandemia


BACKGROUND AND OBJECTIVE: There is a shortage of supplies for the protection of professionals during the COVID-19 pandemic. 3D printing offers the possibility to compensate for the production of some of the equipment needed. The objective is to describe the role of 3D printing in a health service during the COVID-19 pandemic, with an emphasis on the process to develop a final product ready to be implemented in the clinical environment. METHODS: A working group was formed between the healthcare administration, clinicians and other public and private institutions in Cantabria, Spain coordinated by the Valdecilla Virtual Hospital. The process included receiving the printing proposals, learning about the printing resources in the region, selecting the devices, creating a team for each project, prototyping, evaluation and redesign, manufacturing, assembly and distribution. RESULTS: The following supplies are produced: 1) devices that help protect providers: face protection screens (2,400 units), personalized accessories for photophores (20 units) and ear-protection forks for face-masks (1,200 units); 2) products related to the ventilation of infected patients: connectors for non-invasive ventilation systems; and 3) oral and nasopharyngeal swabs (7,500 units) for the identification of coronavirus carriers with the aim of designing action protocols in clinical areas. CONCLUSIONS: 3D printing is a valid resource for the production of protective material for professionals whose supply is reduced during a pandemic


Assuntos
Humanos , Infecções por Coronavirus/prevenção & controle , Dispositivos de Proteção Respiratória/provisão & distribuição , Impressão Tridimensional , Máscaras/provisão & distribuição , Pandemias/estatística & dados numéricos , Precauções Universais/métodos , Pessoal de Saúde/estatística & dados numéricos , Proteção Pessoal
15.
Transl Behav Med ; 10(4): 843-849, 2020 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-32893867

RESUMO

Despite early warnings and calls for action, COVID-19 infection rates continue to climb in many areas of the United States. The current study examined participants' reported likelihood of engaging in eight behaviors designated by the Centers for Disease Control and Prevention as critical for the prevention of COVID-19 at the outset of the epidemic. Self-efficacy, perceived threat, and internal and external health locus of control were explored as potential predictors of those behaviors. In addition, demographic and contextual factors, such as age, gender, political identity, and whether or not participants were currently living under a quarantine advisory, were recorded for analysis. Overall, participants reported high engagement with the prevention behaviors. Higher levels of self-efficacy, perceived severity of the illness, and external locus of control in regard to medical professionals were all positively associated with plans to take the recommended precautions. Based on the results, it appears that messaging regarding COVID-19 prevention may be particularly effective when it focuses on the high risk of the illness, the ease with which the prevention behaviors can be taken, and a reassurance that the medical establishment has individuals' best health in mind when it makes its specific recommendations. While numerous countries have succeeded in reducing the spread of COVID-19, the number of new cases in the United States remains high, even relative to other populations also heavily impacted by the disease [1]. Although it would be difficult to pinpoint a single cause or explanation for the epidemic's course in the USA, at the heart of its spread, like the spread of all infectious diseases, is noncompliance with preventative measures. The current research served as a preliminary exploration of the prevalence and predictors of eight COVID-19 prevention behaviors. A brief survey was sent out at the end of March 2020 to 350 U.S. residents in order to assess the likelihood of their engaging in various prevention behaviors recommended at that time and several related psychosocial factors. The psychological factors assessed included health locus of control (HLOC) beliefs, self-efficacy, and perceived threat. In addition, a handful of demographic and contextual factors, such as age, gender, political identity, and whether or not they were working outside the home or were currently living under a quarantine advisory, were recorded for examination.


Assuntos
Comportamento Cooperativo , Infecções por Coronavirus , Comportamentos Relacionados com a Saúde , Pandemias , Pneumonia Viral , Autoeficácia , Isolamento Social/psicologia , Percepção Social , Adulto , Atitude Frente a Saúde , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/psicologia , Feminino , Humanos , Intenção , Masculino , Máscaras , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/psicologia , Prevalência , Psicologia , Controle Social Formal/métodos , Inquéritos e Questionários , Estados Unidos/epidemiologia , Precauções Universais/métodos , Precauções Universais/estatística & dados numéricos
16.
JBJS Case Connect ; 10(3): e2000288, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32910604

RESUMO

CASE: Coronavirus disease 2019 (COVID-19) is a pandemic respiratory disease. Patients typically present with fever, cough, and radiological lung changes. However, a significant proportion of these patients are asymptomatic. To date, we have limited information on the operations performed on these patients. We report our experience of a relatively asymptomatic elderly patient who underwent surgery for a hip fracture and was confirmed postoperatively to have COVID-19. CONCLUSION: Meticulous hand hygiene and use of surgical mask in daily practice is crucial to protect against asymptomatic and undiagnosed patients.


Assuntos
Doenças Assintomáticas , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Diagnóstico Tardio/prevenção & controle , Fraturas do Colo Femoral/diagnóstico , Hemiartroplastia/métodos , Controle de Infecções , Pandemias , Pneumonia Viral , Idoso de 80 Anos ou mais , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Feminino , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Período Pós-Operatório , Resultado do Tratamento , Precauções Universais/métodos
17.
Pediatr. aten. prim ; 22(87): 241-250, jul.-sept. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-194297

RESUMO

La Asociación Española de Pediatría de Atención Primaria (AEPap) ha elaborado un documento con propuestas para la organización de las consultas de Atención Primaria en la próxima temporada invernal, y así poder garantizar la atención a los pacientes pediátricos, con y sin sospecha de infección por SARS-CoV-2. En dicho documento se insiste en la importancia de que la primera valoración del paciente sea telefónica para orientar a las familias sobre la idoneidad de una visita telemática o de una visita presencial y, en caso de ser así, recibir indicaciones sobre la zona del centro de salud y horario de atención en función de los síntomas, para mantener las medidas de protección y seguridad, tanto del paciente como del personal sanitario. AEPap y SEPEAP proponen que en los centros de salud se organicen dos circuitos, uno para atender pacientes con sospecha de infección por SARS-CoV-2 y otro circuito para valorar el resto de las patologías y llevar a cabo el Programa de Salud Infantil (PSI). Para ello, también insta a las Administraciones públicas a mejorar las herramientas de la telemedicina para garantizar el intercambio seguro de información y así poder realizar consultas no presenciales para evitar contagios en el centro sanitario, dotar a los centros de salud de personal sanitario, administrativo y de limpieza suficiente. También es muy importante que los profesionales sanitarios dispongan de técnicas diagnósticas para descartar las infecciones pediátricas más frecuente en época invernal (rinovirus, virus respiratorio sincitial, gripe, rotavirus) y agilizar el resultado de la reacción en cadena de la polimerasa (PCR) para COVID-19 y así evitar aislamientos innecesarios


The Spanish Association of Primary Care Pediatrics (AEPap), has prepared a document with proposals for the organization of primary care consultations in the next winter season, and thus be able to guarantee care for pediatric patients, with and without suspected infection by SARS-CoV-2. This document insists on the importance that the first assessment of the patient is by telephone to guide families on the suitability of a telematic visit or a face-to-face visit and, if so, receive instructions on the area of the health center and hours of attention based on symptoms, to maintain protection and safety measures for both the patient and the health personnel. The AEPap and the SEPEAP propose to organize two circuits in health centers, one to evaluate patients with suspected SARS-CoV-2 infection and another circuit to assess the rest of the pathologies and carry out the Children's Health Program. For this, it also urges public administrations to improve telemedicine tools to guarantee the safe exchange of information and thus be able to carry out non-face-to-face consultations to avoid infections in the health center, provide health centers with health, administrative, cleaning and medical personnel sufficient. It is also very important that healthcare professionals have diagnostic techniques to rule out the most frequent pediatric infections in winter (rhinovirus, RSV, flu, rotavirus) and speed up the PCR result for Covid-19 and thus avoid unnecessary isolations


Assuntos
Humanos , Criança , Infecções por Coronavirus/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Vírus da SARS/patogenicidade , Cuidado da Criança/métodos , Consenso , Pandemias/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , Pediatria/organização & administração , Precauções Universais/métodos , Infecções por Coronavirus/prevenção & controle
18.
Pediatr. aten. prim ; 22(87): 263-271, jul.-sept. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-194298

RESUMO

INTRODUCCIÓN: durante la pandemia de COVID-19, el uso de equipos y dispositivos de protección por parte de los profesionales es fundamental para evitar la transmisión de la infección en el colectivo de sanitarios. MATERIAL Y MÉTODOS: el Grupo Laboral-Profesional de la Asociación Española de Pediatría de Atención Primaria (AEPap) ha realizado una encuesta a los vocales autonómicos de la AEPap para conocer la disponibilidad que han tenido los pediatras de Atención Primaria (PAP) de sistemas de protección frente a la enfermedad, y las pruebas diagnósticas realizadas para el diagnóstico de los contagios de los PAP. RESULTADOS: en marzo de 2020, solo en el 32% de las comunidades autónomas (CC. AA.), los pediatras tenían sistemas de protección adecuados. En abril ascendió al 70%. En todas las CC. AA. se han registrado casos de PAP enfermos, aunque es difícil cuantificar el número de afectados. De las que tenemos datos, sumando el número de pediatras enfermos conocido, más test de reacción en cadena de la polimerasa (PCR) positivo, los que han estado en aislamiento y los ingresados, la cifra asciende al 7,65% de la cifra total de PAP. Los test rápidos serológicos o PCR o ambos se han realizado en seis comunidades los últimos días de abril y en otras seis los primeros días de mayo. Entre las CC. AA. de las que hay información, Aragón es la única comunidad en la que no se ha realizado test. Se ha correlacionado la disponibilidad de los sistemas de protección y el gasto sanitario. CONCLUSIONES: los sistemas de protección han sido insuficientes. Las CC. AA. con mayor gasto sanitario han contado más precozmente con sistemas de protección adecuados. Han resultado infectados PAP en todas las comunidades autónomas, especialmente en Madrid, Castilla y León y Comunidad Valenciana. La detección de profesionales afectos por la infección ha sido tardía


INTRODUCTION: during the COVID-19 pandemic, the use of protective equipment and devices by professionals is essential to prevent transmission of the infection in the healthcare community. METHODS: the Professional Labor Working group of the Spanish Association of Primary Care Pediatrics (AEPap) has carried out a survey of the autonomous members of the AEPap to find out the availability for primary care pediatricians (PCP) of protection elements against the disease, the diagnostic measures carried out on the professionals for the diagnosis of infections in the PCP. RESULTS: during the month of March, in 32% of the autonomous communities (CC. AA.), pediatricians had adequate means of protection, which in April amounted to 70%. Sick cases of PCP have been registered in all the CC. AA., although it is difficult to quantify the number of patients affected. According to our data, adding the positive test patients, those who have been in isolation and those admitted, the figure rises up to 7.65%. Rapid serological tests or PCR or both have been carried out in 6 communities in the last days of April and in 6 others in the first days of May. The only community in which it has not been carried out is that of Aragon. The availability of protection systems and health expenditure have been correlated. CONCLUSIONS: protection systems have been insufficient. The CC. AA. with the highest health expenditure have had adequate protection systems earlier. PCP have been infected in all the autonomous communities, especially in Madrid, Castilla y León and Valencia. The detection of affected professionals by the infection has been late


Assuntos
Humanos , Criança , Infecções por Coronavirus/prevenção & controle , Síndrome Respiratória Aguda Grave/prevenção & controle , Vírus da SARS/isolamento & purificação , Hospitais Pediátricos/organização & administração , Gestão da Segurança/métodos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Infecções por Coronavirus/epidemiologia , Síndrome Respiratória Aguda Grave/epidemiologia , Vírus da SARS/patogenicidade , Cuidado da Criança/métodos , Pandemias/estatística & dados numéricos , Atenção Primária à Saúde/organização & administração , Precauções Universais/métodos , Pessoal de Saúde/estatística & dados numéricos , Espanha/epidemiologia
19.
Rev. Rol enferm ; 43(9): 579-599, sept. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-194389

RESUMO

El coronavirus SARS-CoV-2 causa COVID-19, una enfermedad cuyas manifestaciones clínicas varían desde una infección asintomática hasta cuadros clínicos graves, incluso con desenlace fatal. Este virus procede de China y en pocos meses se ha extendido por todo el planeta, lo que demuestra una alta capacidad de transmisión. Su transmisión es muy buena en entornos cerrados, poco ventilados, donde haya muchas personas, a poca distancia entre ellas y que no usen mascarillas. El estudio de las medidas preventivas frente a COVID-19 tiene una importancia capital en esta nueva enfermedad, que ha demostrado su agresividad y letalidad, sobre todo porque no se dispone de tratamientos efectivos específicos ni de vacunas comercializadas para su uso poblacional. Esto adquiere mayor importancia, si cabe, cuando se conoce, a través de diversos estudios, que la inmunidad poblacional es en todo el mundo baja o muy baja, a pesar de la agresividad del virus; también en España, como mostró un importante estudio longitudinal seroepidemiológico de base poblacional en el ámbito nacional. A pesar de la ausencia de tratamientos efectivos específicos y de vacunas comercializadas, la población debe convivir con el virus hasta que pueda ser vencido definitivamente. La sociedad no puede pararse indefinidamente y debe seguir adelante, aplicando las recomendaciones para prevenir la infección por el virus. En este contexto resulta clave poner en marcha el sistema educativo presencial y las residencias de mayores, dos actores imprescindibles en nuestra sociedad. Para su funcionamiento de la forma más segura posible, se requiere aplicar las medidas preventivas con efectividad y conocimiento. En este artículo se expone una aproximación a los factores de riesgo poblacional frente al virus y a las medidas preventivas de aplicación poblacional más significativas para reducir la transmisión del coronavirus SARS-CoV-2 basadas en la evidencia científica actual. Para ello se ha realizado una revisión de la bibliografía disponible en PubMed (inglés y castellano) sobre prevención de la infección por coronavirus SARS-CoV-2, sin limitación de rango temporal dado el reciente comienzo de la afectación humana conocida, y en instituciones y entidades de referencia. La ventilación con aire exterior, la higiene de manos frecuente (lavado o aplicación de gel hidroalcohólico), el distanciamiento social, evitar aglomeraciones, la limpieza y desinfección de objetos y superficies y el uso de mascarillas son las medidas preventivas de aplicación general que pueden considerarse de más impacto. No hay que olvidar otras como, por ejemplo, no fumar


Coronavirus SARS-CoV-2 causes COVID-19, a disease whose clinical manifestations can vary from an asymptomatic infection to a severe medical condition (including death). This virus comes from China and, in a few months, it has spread throughout the planet, proving to have a high transmission rate. A transmission which is excellent in closed, poorly ventilated environments, where there are many people with a short distance between them. Studying useful preventive measures against COVID-19 has a great importance in fighting this new disease, which has proved its high aggressiveness and lethality, especially since no specific treatments or vaccines are available on the market at the present. This becomes even more important when it is known that population immunity is low or very low over the world, including Spain, despite the aggressiveness of the virus, as an important population-based seroepidemiological longitudinal study showed at the national level. Despite the absence of specific effective treatments and marketed vaccines, the population must live with the virus until it can be definitively defeated. Society cannot stop indefinitely and must move forward, applying the recommendations to prevent the infection with the virus to the entire population. In this context, implementing these measures in an in-person education system and in the residences of the elderly (two essential actors in our society) is a key to fight the pandemic. To operate as safely as possible, preventive measures are required apply with effectiveness and knowledge. This article outlines an approximation of population risk factors against the virus and the most significant preventive measures of popular application to reduce the transmission of SARC-CoV-2 coronavirus based on current scientific evidence. To achieve this, a review of the available literature in PubMed (English and Spanish) on the prevention of coronarivus infection has been carried out, without limitation of temporal range given the recent beginning of known human involvement. Ventilation with outdoor air, frequent hands hygiene, social distancing, avoiding crowds, cleaning and disinfection of objects and surfaces and the use of masks are the preventive measures of general application that can be considered of the greatest impact. Do not forget others such as not smoking


Assuntos
Humanos , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa/prevenção & controle , Controle de Doenças Transmissíveis/métodos , Precauções Universais/métodos , Síndrome Respiratória Aguda Grave/prevenção & controle , Vírus da SARS/patogenicidade , Instituição de Longa Permanência para Idosos/organização & administração , Instituições Acadêmicas/organização & administração , Centros de Saúde
20.
Hosp. domic ; 4(3): 133-152, jul.-sept. 2020. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-192943

RESUMO

PROPÓSITO: Ante la crisis sanitaria que vive el país y el mundo actualmente, se confeccionó este documento por la iniciativa autónoma de kinesiólogos de doce unidades de Hospitalización Domiciliaria (HD) de hospitales públicos de Chile, con el fin de unificar criterios en base a sus experiencias y la evidencia científica disponible para poder realizar una atención kinésica respiratoria segura en pacientes con sospecha o confirmados para COVID-19. Además, este documento tiene el objetivo de ser una guía para quienes tengan la necesidad de protocolizar y/o estandarizar su atención en HD, pudiendo ser adaptado según la necesidad y disponibilidad de recursos e infraestructura de cada unidad. Es importante señalar, que este documento puede variar según la evolución de esta pandemia y la actualización de la evidencia científica. CAMPO DE APLICACIÓN: Este documento está diseñado para ser aplicado en el domicilio de los pacientes adultos y pediátricos ingresados a las Unidades de Hospitalización Domiciliaria (UHD) con sospecha de infección por SARS-CoV-2 o con resultado positivo para COVID-19


PURPUSE: Given the health crisis that the country and the world are currently experiencing, this document was prepared by the autonomous initiative of kinesiologists from twelve Hospital at Home units of public hospitals in Chile, in order to unify criteria based on their experiences and the available scientific evidence in order to carry out safe respiratory physiotherapy care in patients with suspected or confirmed COVID-19. In addition, this document is intended to be a guide for those who need to protocolize and / or standardize their care at Hospital at home, and can be adapted according to the need and availability of resources and infrastructure of each unit. It is important to note that this document may vary depending on the evolution of this pandemic and the updating of scientific evidence. SCOPE: This document is designed to be applied in the home of adult and pediatric patients admitted to Hospital at Home Units (UHD) with suspected SARS-CoV-2 infection or with a positive result for COVID-19


Assuntos
Humanos , Exercícios Respiratórios/métodos , Síndrome Respiratória Aguda Grave/reabilitação , Vírus da SARS/patogenicidade , Infecções por Coronavirus/epidemiologia , Modalidades de Fisioterapia/organização & administração , Serviços Hospitalares de Assistência Domiciliar/organização & administração , Controle de Doenças Transmissíveis/métodos , Ventilação não Invasiva/estatística & dados numéricos , Precauções Universais/métodos , Guias como Assunto
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