Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 7.209
Filtrar
2.
Can J Surg ; 63(5): E431-E434, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33009897

RESUMO

SUMMARY: Hepato-pancreato-biliary (HPB) injuries can be extremely challenging to manage. This scoping review (8438 citations) offers a number of recommendations. If diagnosis and therapy are rapid, patients with major hepatic injuries who present in physiologic extremis have high survival rates despite prolonged hospital stays. Nonoperative management of major liver injuries, as diagnosed using computed tomography, is typically successful. Adjuncts (e.g., angioembolization, laparoscopic washouts, biliary stents) are essential in managing high-grade injuries. Injury to the extrahepatic biliary tree is rare. Cholecystectomy is indicated for all gallbladder trauma. Full-thickness common bile duct injuries require a hepaticojejunostomy, although damage control remains closed suction drainage. Injuries to the pancreatic head often involve concurrent trauma to regional vasculature. Damage control necessitates drainage after stopping hemorrhage. Injury to the left pancreas commonly requires a distal pancreatectomy. Outcomes for high-grade pancreatic and liver injuries are improved by involving an HPB team. Complications are multidisciplinary and should be managed without delay.


Assuntos
Traumatismos Abdominais/terapia , Sistema Biliar/lesões , Fígado/lesões , Pâncreas/lesões , Traumatismos Abdominais/complicações , Traumatismos Abdominais/diagnóstico , Traumatismos Abdominais/mortalidade , Sistema Biliar/diagnóstico por imagem , Tratamento Conservador/efeitos adversos , Tratamento Conservador/métodos , Tratamento Conservador/normas , Tratamento Conservador/estatística & dados numéricos , Humanos , Fígado/diagnóstico por imagem , Pâncreas/diagnóstico por imagem , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Guias de Prática Clínica como Assunto , Índice de Gravidade de Doença , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Procedimentos Cirúrgicos Operatórios/métodos , Procedimentos Cirúrgicos Operatórios/normas , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Fatores de Tempo , Tempo para o Tratamento/normas , Tomografia Computadorizada por Raios X , Resultado do Tratamento
3.
Surg Clin North Am ; 100(5): 909-920, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32882173

RESUMO

Advanced technology has resulted in major changes in surgery and medicine over the past three decades. There are many barriers to the adoption of advanced technologies, which can be more prevalent in rural hospitals and surgical practices. Despite barriers to implementation of new technologies in rural communities, many rural hospitals have endorsed and invested in these technologies for the benefit of the hospital and community. The rural surgeon is often the driving force in evaluating and deciding on new technologies for their surgical program. This article discusses advantages, challenges, and limitations in the use of advanced technologies in rural locations.


Assuntos
Tecnologia Biomédica , Cirurgia Geral/métodos , Serviços de Saúde Rural , Procedimentos Cirúrgicos Operatórios/métodos , Hospitais Rurais , Humanos , Procedimentos Cirúrgicos Robóticos , Telemedicina , Estados Unidos
4.
Am Surg ; 86(9): 1129-1134, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32955355

RESUMO

INTRODUCTION: Using the National Cancer Database (NCDB), we seek to analyze the relationship of patient distance to hospital of treatment on mortality trends after surgery, since patients often travel large distances to referral centers. METHODS: A retrospective cohort study of the NCDB from 2004 to 2013 was performed, and patients with gastrointestinal, melanoma, and head and neck primary site tumors who underwent surgery were included. We excluded cases with no recorded mortality status or distance from the hospital. A multivariable logistic regression was conducted with adjustments for population density, treating facility location, age, race, gender, education, income, insurance, comorbidities (Charlson-Deyo score), days from diagnosis to treatment, positive margin, tumor stage and grade, and lymph or vascular invasion. RESULTS: A total of 1 424 482 patients were included. Overall median distance to hospital was 9.7 miles (range 4.2-23.7 miles); 696 647 (48.91%) of the sample traveled a distance greater than 10 miles to the institution where the procedure was performed. The multivariable regression analysis demonstrated overall lower mortality for those patients travelling a longer distance to care for multiple tumor types, including: liver (OR .87, .77-.99, P = .032), pancreas (OR .82, .76-.89, P < .001), colon (OR .92, .89-.95, P < .001), rectum (OR .90, .83-.96, P = .003), melanoma (OR .83, .79-.88, P < .001), and tumors of the larynx (OR .80, .69-.94, P = .005). DISCUSSION: Increased distance traveled for surgical treatment has a significant correlation with decreased odds of mortality for multiple cancers, highlighting the importance of centralized referral patterns for oncology care.


Assuntos
Neoplasias/mortalidade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Sistema de Registros , Procedimentos Cirúrgicos Operatórios/métodos , Tempo para o Tratamento/estatística & dados numéricos , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/cirurgia , Estudos Retrospectivos , Taxa de Sobrevida/tendências , Estados Unidos/epidemiologia
5.
Anesth Analg ; 131(4): 1228-1236, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32925344

RESUMO

BACKGROUND: Recent limited evidence suggests that the use of a processed electroencephalographic (EEG) monitor to guide anesthetic management may influence postoperative cognitive outcomes; however, the mechanism is unclear. METHODS: This exploratory, single-center, randomized clinical trial included patients who were ≥65 years of age undergoing elective noncardiac surgery. The study aimed to determine whether monitoring the brain using a processed EEG monitor reduced EEG suppression and subsequent postoperative delirium. The interventional group received processed EEG-guided anesthetic management to keep the Patient State Index (PSI) above 35 computed by the SEDline Brain Function Monitor (Masimo, Inc, Irvine, CA), while the standard care group was also monitored, but the EEG data were blinded from the clinicians. The primary outcome was intraoperative EEG suppression. A secondary outcome was incident postoperative delirium during the first 3 days after surgery. RESULTS: All outcomes were analyzed using the intention-to-treat paradigm. Two hundred and four patients with a mean age of 72 ± 5 years were studied. Minutes of EEG suppression adjusted by the length of surgery was found to be less for the interventional group than the standard care group (median [interquartile range], 1.4% [5.0%] and 2.5% [10.4%]; Hodges-Lehmann estimated median difference [95% confidence interval {CI}] of -0.8% [-2.1 to -0.000009]). The effect of the intervention on EEG suppression differed for those with and without preoperative cognitive impairment (interaction P = .01), with the estimated incidence rate ratio (95% CI) of 0.39 (0.33-0.44) for those with preoperative cognitive impairment and 0.48 (0.44-0.51) for those without preoperative cognitive impairment. The incidence of delirium was not found to be different between the interventional (17%) and the standard care groups (20%), risk ratio = 0.85 (95% CI, 0.47-1.5). CONCLUSIONS: The use of processed EEG to maintain the PSI >35 was associated with less time spent in intraoperative EEG suppression. Preoperative cognitive impairment was associated with a greater percent of surgical time spent in EEG suppression. A larger prospective cohort study to include more cognitively vulnerable patients is necessary to show whether an intervention to reduce EEG suppression is efficacious in reducing postoperative delirium.


Assuntos
Monitores de Consciência , Eletroencefalografia , Monitorização Neurofisiológica Intraoperatória/métodos , Procedimentos Cirúrgicos Operatórios/métodos , Idoso , Idoso de 80 Anos ou mais , Anestesia , Anestésicos/administração & dosagem , Disfunção Cognitiva/epidemiologia , Disfunção Cognitiva/etiologia , Delírio/epidemiologia , Delírio/etiologia , Delírio do Despertar/epidemiologia , Feminino , Humanos , Incidência , Masculino , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/psicologia , Estudos Prospectivos
6.
Med Clin North Am ; 104(5): 895-908, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32773053

RESUMO

Geriatric patients are not just older adult patients. Aging brings about unique physiologic, psychological, and sociologic changes within individuals. Recognition of these unique characteristics and measuring for their impact; instituting mitigating strategies; using age-specific anesthetic measures; and performing a systematic, algorithmic care model in the postoperative period overseen by a multidisciplinary team brings about enhanced outcomes and improved quality of care for this expanding group of patients.


Assuntos
Envelhecimento , Cuidados Pós-Operatórios/métodos , Complicações Pós-Operatórias , Procedimentos Cirúrgicos Operatórios , Idoso , Envelhecimento/fisiologia , Envelhecimento/psicologia , Avaliação Geriátrica/métodos , Humanos , Seleção de Pacientes , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/prevenção & controle , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Procedimentos Cirúrgicos Operatórios/métodos
8.
Aging (Albany NY) ; 12(15): 15771-15783, 2020 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-32805726

RESUMO

During the COVID-19 outbreak, some patients with COVID-19 pneumonia also suffered from acute abdomen requiring surgical treatment; however, there is no consensus for the treatment of such patients. In this study, we retrospectively reviewed 34 patients with acute abdomen who underwent emergency surgery during the COVID-19 outbreak. Among the 34 patients with acute abdomen, a total of six cases were found with COVID-19 pneumonia (clinical classification for COVID-19 pneumonia: all were the common type). On the premise of similar demographics between both groups, patients with COVID-19 pneumonia had worse indicators of liver and coagulation function. Compared with acute abdomen patients without COVID-19, patients with COVID-19 pneumonia had a longer hospital stay, but there were no significant differences in postsurgical complications (P = 0.58) or clinical outcomes (P = 0.56). In addition, an obvious resolution of lung inflammation after surgery was observed in five COVID-19 patients (83.3%). No new COVID-19 cases occurred during the patients' hospital stays. Therefore, for the common type of COVID-19 pneumonia, emergency surgery could not only improve the outcomes of COVID-19 pneumonia patients with acute abdomen, but also benefit the resolution of pulmonary inflammation.


Assuntos
Abdome Agudo , Infecções por Coronavirus , Tratamento de Emergência , Gastroenteropatias , Pandemias , Pneumonia Viral , Procedimentos Cirúrgicos Operatórios , Abdome Agudo/diagnóstico , Abdome Agudo/epidemiologia , Abdome Agudo/etiologia , Abdome Agudo/cirurgia , Idoso , Betacoronavirus/isolamento & purificação , Testes de Coagulação Sanguínea/métodos , China/epidemiologia , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Tratamento de Emergência/métodos , Tratamento de Emergência/estatística & dados numéricos , Feminino , Gastroenteropatias/epidemiologia , Gastroenteropatias/fisiopatologia , Humanos , Tempo de Internação/estatística & dados numéricos , Testes de Função Hepática/métodos , Masculino , Pessoa de Meia-Idade , Avaliação de Processos e Resultados em Cuidados de Saúde , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Pneumonia Viral/fisiopatologia , Pneumonia Viral/terapia , Procedimentos Cirúrgicos Operatórios/métodos , Procedimentos Cirúrgicos Operatórios/tendências
10.
Int J Nanomedicine ; 15: 3869-3875, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32764920

RESUMO

Introduction: During routine surgery, rapid hemostasis, especially the rapid hemostasis of internal organs, is very important. The emergence of in-situ electrospinning technology has fundamentally solved this problem. It exhibits a high speed of hemostasis, and no bleeding occurs after surgery. Thus, it is of great significance. The use of sutures in some human organs, such as the intestines and bladder, is inadequate because fluid leakage occurs due to the presence of pinholes. Methods: Three types of large intestine wounds with an opening of about 1 cm were investigated. They were untreated, treated by needle and threaded, and treated by hand-held electrospinning, respectively. Results: The results show that hand-held electrospinning technique effectively prevented the exudation of fluids in the intestinal tract. The average diameter of the nanofibrous membrane was about 0.5 µm with hole of several micrometers. It can be elongated 90% without breakage. The hand-held electrospinning device could be used with nitrile gloves, preventing the risk of infection caused by exposed hands. Discussion: This work can provide a reference for future animal experiments and clinical experiments. However, safety should be investigated before application.


Assuntos
Eletricidade , Hemostasia , Mucosa Intestinal/metabolismo , Procedimentos Cirúrgicos Operatórios/métodos
13.
Zhonghua Wai Ke Za Zhi ; 58(8): 642-645, 2020 Aug 01.
Artigo em Chinês | MEDLINE | ID: mdl-32727197

RESUMO

With the development and progress in the concepts and techniques of perioperative management, especially the latest reports of clinical trials, the prospect of prevention and treatment of postoperative ileus (POI) is promising. Proper nutritional support therapy, optimized surgical and anesthetic treatment, individualized fluid management, timely psychosocial intervention, and active anti-inflammation and traditional Chinese medicine treatment can effectively reduce occurrence of POI. Nevertheless, how to optimize and combine perioperative treatments to comprehensively prevent and treat POI still needs further study.


Assuntos
Íleus/prevenção & controle , Assistência Perioperatória/métodos , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Humanos , Íleus/etiologia , Íleus/terapia , Procedimentos Cirúrgicos Operatórios/métodos
14.
Int J Surg ; 80: 194-201, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32693151

RESUMO

BACKGROUND: After the emergence of Covid-19 in China, Hubei Province, the epidemic quickly spread to Europe. France was quickly hit and our institution was one of the first French university to receive patients infected with Sars-COV2. The predicted massive influx of patients motivated the cancellation of all elective surgical procedures planned to free hospitalization beds and to free intensive care beds. Nevertheless, we should properly select patients who will be canceled to avoid life-threatening. The retained surgical indications are surgical emergencies, oncologic surgery, and organ transplantation. MATERIAL AND METHODS: We describe the organization of our institution which allows the continuation of these surgical activities while limiting the exposure of our patients to the Sars Cov2. RESULTS: After 4 weeks of implementation of intra-hospital protocols for the control of the Covid-19 epidemic, 112 patients were operated on (104 oncology or emergency surgeries and 8 liver transplants). Only one case of post-operative contamination was observed. No mortality related to Covid-19 was noted. No cases of contamination of surgical care personnel have been reported. CONCLUSION: We found that the performance of oncological or emergency surgery is possible, safe for both patients and caregivers.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Centro Cirúrgico Hospitalar/organização & administração , Procedimentos Cirúrgicos Operatórios/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos do Sistema Digestório , Procedimentos Cirúrgicos Eletivos/métodos , Emergências , Feminino , França/epidemiologia , Procedimentos Cirúrgicos em Ginecologia , Instalações de Saúde , Humanos , Transplante de Fígado/métodos , Pulmão/diagnóstico por imagem , Masculino , Programas de Rastreamento , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Otorrinolaringológicos , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Melhoria de Qualidade , Reação em Cadeia da Polimerase em Tempo Real , Estudos Retrospectivos , Centros de Atenção Terciária , Tomografia Computadorizada por Raios X
16.
Ann Surg ; 272(2): 277-283, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32675540

RESUMO

: Since their discovery, neutrophil extracellular traps (NETs) have been implicated in a broad array of functions, both beneficial and detrimental to the host. Indeed, NETs have roles in infection, sepsis, wound healing, thrombotic disease, and cancer propagation, all of which are directly implicated in the care of surgical patients. Here we provide an updated review on the role of NETs in the perioperative period with specific emphasis on perioperative infections, wound healing, vascular complications, cancer propagation, as well as discussing ongoing, and future therapeutic targets. Surgeons will benefit from understanding the latest discoveries in neutrophil biology and how these novel functions affect the care of surgical patients. Furthermore, novel anti-NET therapies are being developed which may have profound effects on the care of surgical patients.


Assuntos
Armadilhas Extracelulares/metabolismo , Neutrófilos/metabolismo , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Procedimentos Cirúrgicos Operatórios/métodos , Infecção da Ferida Cirúrgica/metabolismo , Cicatrização/fisiologia , Animais , Biomarcadores/metabolismo , Feminino , Humanos , Masculino , Camundongos , Assistência Perioperatória/métodos , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/metabolismo , Medição de Risco , Sensibilidade e Especificidade , Infecção da Ferida Cirúrgica/diagnóstico
17.
Ann Surg ; 272(2): 304-310, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32675543

RESUMO

OBJECTIVE: To describe if patients with chronic opioid use with a consistent usual prescriber (UP) prior to surgery and if early return to that UP (<30 d) would be associated with fewer high risk prescribing events in the postoperative period. SUMMARY BACKGROUND DATA: Over 10 million people each year are prescribed opioids for chronic pain. There is little evidence regarding coordination of opioid management and best practices for patients on long-term opioid therapy patients following surgery. METHODS: The study design is a retrospective cohort study. We identified 5749 commercially insured patients aged 18 to 64 with chronic opioid use who underwent elective surgery between January 2008 and March 2015. The predictors were presence of a UP and early return (<30 d from surgery) to a UP. The primary outcome was new high-risk opioid prescribing in the 90-day postoperative period (multiple prescribers, overlapping opioid and/or benzodiazepine prescriptions, new long acting opioid prescriptions, or new dose escalations to > 100 mg OME). RESULTS: In this cohort, 73.8% of patients were exposed to high risk prescribing postoperatively. Overall, 10% of patients did not have a UP preoperatively, and were more likely to have prescriptions from multiple prescribers (OR 2.23 95% CI 1.75-2.83) and new long acting opioid prescriptions (OR 1.69, 95% CI 1.05-2.71). Among patients with a UP, earlier return was associated with decreased odds of receiving prescriptions from multiple prescribers (OR 0.80, 95% CI 0.68-0.95). CONCLUSION: Patients without a UP prior to surgery are more likely to be exposed to high-risk opioid prescribing following surgery. Among patients who have a UP, early return visits may enhance care coordination with fewer prescribers.


Assuntos
Analgésicos Opioides/administração & dosagem , Uso de Medicamentos/estatística & dados numéricos , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Dor Pós-Operatória/tratamento farmacológico , Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Adolescente , Adulto , Fatores Etários , Analgésicos Opioides/efeitos adversos , Dor Crônica/tratamento farmacológico , Estudos de Coortes , Feminino , Seguimentos , Humanos , Incidência , Modelos Logísticos , Masculino , Michigan , Pessoa de Meia-Idade , Análise Multivariada , Transtornos Relacionados ao Uso de Opioides/epidemiologia , Manejo da Dor/métodos , Dor Pós-Operatória/diagnóstico , Equipe de Assistência ao Paciente/organização & administração , Padrões de Prática Médica , Valor Preditivo dos Testes , Estudos Retrospectivos , Medição de Risco , Índice de Gravidade de Doença , Fatores Sexuais , Procedimentos Cirúrgicos Operatórios/efeitos adversos , Procedimentos Cirúrgicos Operatórios/métodos , Adulto Jovem
18.
Surg Today ; 50(8): 794-808, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32651686

RESUMO

In this unprecedented COVID-19 pandemic, several key issues must be addressed to ensure safe treatment and prevent rapid spread of the virus and a consequential medical crisis. Careful evaluation of a patient's condition is crucial for deciding the triage plan, based on the status of the disease and comorbidities. As functionality of the medical care system is greatly affected by the environmental situation, the treatment may differ according to the medical and infectious disease circumstances of the institution. Importantly, all medical staff must prevent nosocomial COVID-19 by minimizing the effects of aerosol spread and developing diagnostic and surgical procedures. Polymerase chain reaction (PCR) screening for COVID-19 infection, particularly in asymptomatic patients, should be encouraged as these patients are prone to postoperative respiratory failure. In this article, the Japan Surgical Society addresses the general principles of surgical treatment in relation to COVID-19 infection and advocates preventive measures against viral transmission during this unimaginable COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Saúde do Trabalhador , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Procedimentos Cirúrgicos Operatórios/métodos , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos/métodos , Feminino , Humanos , Japão , Masculino , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Medição de Risco , Sociedades Médicas/normas , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Triagem/métodos
19.
Female Pelvic Med Reconstr Surg ; 26(8): 477-482, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32604203

RESUMO

OBJECTIVES: The primary objective of the study was to evaluate patients' attitudes toward the postponement of their scheduled procedures for pelvic floor disorders (PFD) because of the COVID-19 pandemic. Secondary objectives were to identify patients who were upset with the postponement of their PFD procedures and to identify factors that are associated with being upset because of the delay in care. METHODS: This was a cross-sectional, survey-based study of women from a single urban, academic practice using a novel questionnaire. The study cohort included women whose PFD surgeries or office procedures were postponed between March 17 and April 30, 2020. RESULTS: Ninety-eight women had surgeries postponed; 68 (70%) responded to our questionnaire. Nearly half of the respondents (32/68, 47.1%) were upset about their procedures being postponed. Upset patients reported a greater impact of PFD symptoms on their mood than those who were not upset (P=0.002). Those who were upset were also more likely to report feelings of isolation (P=0.006), fear that their PFD would worsen because of delayed care (P < 0.001), and anxiety over surgery postponement (P < 0.001) than those who were not upset about the delays. When controlling for anxiety, social isolation, and impact of PFD symptom, anxiety (adjusted odds ratio = 15.7; 95% confidence interval = 3.7-66.6) and feeling of isolation (adjusted odds ratio = 9.7; 95% confidence interval = 1.5-63.7) remained associated with increased odds of being upset because of procedure delays. CONCLUSIONS: Half of women whose pelvic reconstructive procedures were postponed because of the COVID-19 pandemic were upset because of the delay in care, especially those who are emotionally and socially vulnerable during the COVID-19 pandemic.


Assuntos
Infecções por Coronavirus , Controle de Infecções/métodos , Pandemias , Distúrbios do Assoalho Pélvico , Pneumonia Viral , Angústia Psicológica , Procedimentos Cirúrgicos Operatórios , Tempo para o Tratamento , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Inovação Organizacional , Pandemias/prevenção & controle , Distúrbios do Assoalho Pélvico/psicologia , Distúrbios do Assoalho Pélvico/cirurgia , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Procedimentos Cirúrgicos Operatórios/métodos , Procedimentos Cirúrgicos Operatórios/psicologia , Inquéritos e Questionários
20.
Am Surg ; 86(7): 736-740, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32683948

RESUMO

The number of deaths and infected people by Corona-19 virusin 2020 around the world is alarming and numbing at the same time. It almostdifficult to remember when the world was normal, although it just started fewmonths ago. Our world and everything around have changed, our surgical practicehas changed, our life has changed, but Intensive Care Units (ICU)in WestchesterMedical center in Valhalla, NY, continue to care for the sickest of thesickest. But this time, different disease with different prognosis. Everycritical care specialist, every surgery resident and surgical critical carefellow, are COVID-19 doctors. As I round in the ICU, I imagine myself in one ofthose beds that I could have been few weeks ago. Now, fully recovered fromCOVID-19, and coming back to work is a real treat. Yet, I still have morequestions than answers.


Assuntos
Causas de Morte , Infecções por Coronavirus/epidemiologia , Cuidados Críticos/organização & administração , Controle de Infecções/métodos , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Procedimentos Cirúrgicos Operatórios/mortalidade , Centros Médicos Acadêmicos/estatística & dados numéricos , Infecções por Coronavirus/prevenção & controle , Feminino , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva/organização & administração , Masculino , New York , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Procedimentos Cirúrgicos Operatórios/métodos , Análise de Sobrevida
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA