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2.
Rev Assoc Med Bras (1992) ; 66(9): 1203-1209, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33027446

RESUMO

INTRODUCTION: Currently there has been significant growth in the number of patients with suspected obstructive sleep apnea (OSA) referred to sleep clinics. In this sense, screening and stratification methods of the severity of this pathology have become increasingly relevant. OBJECTIVE: To evaluate the performance of the NoSAS and STOP-Bang scores in the screening of OSA in a sleep clinic. METHODS: Prospectively, for 12 months, all patients referred by primary care physicians to our sleep unit for clinical evaluation and who underwent in-lab polysomnography (PSG), also completed the NoSAS score (Neck circumference, Obesity, Snoring, Age, Sex) and STOP-Bang (Snoring, Tiredness, Observed apnea, Pressure (high blood), BMI, Age, Neck circumference, Gender). A ROC (receiver operating characteristic) analysis was used to find the scores that simultaneously maximize sensitivity and specificity for each diagnosis. RESULTS: Of the 294 individuals included, 84% had OSA, of which 28.8% were mild, 34.8% moderate, and 36.4% were severe. USING THE NOSAS SCORE FOR PREDICTING OSA, MODERATE TO SEVERE OSA, AND SEVERE OSA, THE ROC AREA WAS: 0.770 (95% CI: 0.703-0.837), p<0.001, sensitivity of 57.5%, and specificity of 83.0% for a score of 12; 0.746 (95% CI: 0.691-0.802), p<0.001, sensitivity of 68.2% and specificity of 75.4% for a score of 13; 0.686 (95% CI: 0.622-0.749), p<0.001, sensitivity of 71.1% and specificity of 58.3% for a score of 13, respectively. USING THE STOP-BANG SCORE FOR PREDICTING OSA, MODERATE TO SEVERE OSA, AND SEVERE OSA, THE ROC AREA WAS: 0.862 (95% CI: 0.808-0.916), p<0.001, sensitivity of 68.4% and specificity of 85.1% for a score of 5; 0.813 (95% CI: 0.756-0.861), p<0.001, sensitivity of 77.3% and specificity of 66.1% for a score of 5; 0.787 (95% CI: 0.732-0.841), p<0.001, sensitivity of 70.0% and specificity of 79.9% for a score of 6, respectively. CONCLUSIONS: The ROC area was consistently high for both scores confirming the diagnostic ability of the NoSAS and STOP-Bang questionnaires for all OSA severities. Thus, our results suggest that these questionnaires may be a powerful tool for the screening and stratification of patients in the diagnosis of OSA. Overall, the diagnostic ability of the STOP-Bang was higher than the NoSAS.


Assuntos
Apneia Obstrutiva do Sono , Humanos , Programas de Rastreamento , Polissonografia , Ronco , Inquéritos e Questionários
3.
Artigo em Chinês | MEDLINE | ID: mdl-33040505

RESUMO

Objective:The STOP-Bang(S-B) questionnaire is widely used for screening patients with OSA. However, BMI and NC cutoff value in the original S-B questionnaire is 35 kg/m²and 40cm, the BMI and NC value in the young and middle-aged female patients in China is lower than that. We aimed to establish a more appropriate modified STOP-Bang(MS-B) questionnaire. Method:A total of 523 cases with suspected OSA in the young and middle-aged female were included in this study. All patients were asked to completed the S-B, MS-B questionnaire and undergo overnight polysomnography(PSG). The BMI and NC value of the MS-B were determined by the optimal operating points of the ROC. The ability of S-B and MS-B were assessed by ROC and McNemar's test. Result:BMI=28 kg/m²and NC=36 cm as alternative cutoff is to refine S-B questionnaire. When taking apnea hypopnea index(AHI) ≥5 times/h, ≥15 times/h and ≥30 times/h as cut-offs, MS-B had higher sensitivity(88.7% vs 86.7%, 92.8% vs 87.7%, 95.0% vs 90.1%, respectively) and the area under the curve(0.74 vs 0.706, 0.734 vs 0.703, 0.739 vs 0.699, respectively) than S-B. There were significant differences in McNemar test(P<0.05). Conclusion:This study examined the clinical utility of MS-B. MS-B may improve predictive performance of S-B questionnaire in the young and middle-aged female with OSA.


Assuntos
Apneia Obstrutiva do Sono , China/epidemiologia , Feminino , Humanos , Programas de Rastreamento , Pessoa de Meia-Idade , Polissonografia , Apneia Obstrutiva do Sono/diagnóstico , Inquéritos e Questionários
4.
Medicine (Baltimore) ; 99(41): e22382, 2020 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-33031273

RESUMO

BACKGROUND: Mammography is considered a fundamental part of diagnosis in modern health care services. It provides low dose images of normal structures and pathological soft tissues in the breast. Many reports suggested that intervention is playing a positive role in anxiety related to mammography, but there is no high-quality evidence to prove its effects. This paper reports the protocol of a systematic review (SR) and meta-analysis (MA) to clarify effectiveness of intervention during screening mammography. METHODS: A systematic literature search will be performed in the Cochrane Library, PubMed, Embase and Web of Science from inception to July 2020. Randomized controlled trials (RCTs) will be included to evaluate any interventions in the treatment of anxiety related to mammography screening. The main outcome measure is the impact on patient anxiety, and the impact on patient breast cancer worry, the impact on patient satisfaction are the additional outcome measure. Risk of bias assessment of the included RCTs will be carried out using Cochrane Collaboration's tool for RCTs. The Review Manager 5.4 for Windows will be used to perform the MA and generate the result figures. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) will be used to evaluate the quality of evidence. Subgroup analysis and sensitivity analysis will be conducted to assess the robustness of the results. RESULTS: A total of 782 English studies of anxiety related to mammography screening were obtained through search. After preliminary screening, 773 non-conforming studies were excluded. Finally, nine English studies of anxiety related to mammography screening will be included for full-text assessment. We will submit the results of this SR and MA to a peer-reviewed journal for publication. CONCLUSIONS: This study will provide reliable evidence for intervention for reducing anxiety in women receiving screening mammography. INPLASY REGISTRATION NUMBER: INPLASY202070131.


Assuntos
Ansiedade/prevenção & controle , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/psicologia , Projetos de Pesquisa , Detecção Precoce de Câncer , Feminino , Humanos , Mamografia , Programas de Rastreamento , Metanálise como Assunto , Revisões Sistemáticas como Assunto
5.
Rev Prat ; 70(5): 555-560, 2020 May.
Artigo em Francês | MEDLINE | ID: mdl-33058647

RESUMO

How to reduce the sudden nontraumatic death related to sport risk? Sport's related sudden cardiac death (SCD) is still dramatically perceived and often widely publicized. In case of SCD sport's practice reveals a heart disease that is mainly overlooked. In a society under the influence of the precautionary principle, preventing SCD seems essential. However, implementing effective SCD prevention is not easy. Among the three most often preventive actions proposed, the pre-participation screening evaluation, the athlete's education, and the population education for resuscitation maneuvers, the pre-participation evaluation currently seems to have the most difficulty in proving its effectiveness.


Assuntos
Cardiopatias , Esportes , Atletas , Morte Súbita Cardíaca/epidemiologia , Morte Súbita Cardíaca/etiologia , Morte Súbita Cardíaca/prevenção & controle , Humanos , Programas de Rastreamento
6.
Rev Esp Salud Publica ; 942020 Sep 18.
Artigo em Espanhol | MEDLINE | ID: mdl-32945290

RESUMO

OBJECTIVE: The Spanish registry of Covid-19 in Spanish pregnant women, made up of 100 centers, is created in response to the need to know the morbidity that Covid-19 generates in pregnant women and their newborns, to know the real incidence of the disease in this population group and to establish and monitor the package of measures to improve their care. The aim of this paper was the creation of a registry of pregnant women with Covid-19 infection in order to establish the interventions and measures necessary to improve the care of these patients during hospital admission. METHODS: To prepare the registry, the main researcher of each center collected weekly / biweekly the number of total pregnant women screened, as well as the total number of positive and negative, sending these data to the responsible researchers so that it could be available in real time of the percentage of infected asymptomatic pregnant population and the evolution by weeks in the centers of each participating province. The data were analyzed using the linear regression test and the Mantel test. RESULTS: As of May 31stsup> 2020, 16,308 screening tests were carried out in these hospitals, in which 338 pregnant women were positive, which translates into 2.07% (95% Confidence Interval: 1.86-2.30) of the asymptomatic pregnant women we attended in our centers were carriers of the virus and could develop the disease in subsequent days. CONCLUSIONS: The Spanish epidemiological registry allows us to know the incidence of infection in pregnant women attended in the Spanish delivery centers, as well as the weekly and / or fortnightly evolution of the same, observing a significant decrease in the proportion of positive pregnant women over the total of screenings throughout this period, with an average of 6.5% in early April 2020 to an average of 0.93% positive in late May 2020.


Assuntos
Betacoronavirus , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Programas de Rastreamento , Pneumonia Viral/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Sistema de Registros , Adulto , Doenças Assintomáticas , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico/métodos , Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Feminino , Humanos , Incidência , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Gravidez , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/terapia , Espanha/epidemiologia
7.
J Korean Med Sci ; 35(35): e321, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32893522

RESUMO

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has posed significant global public health challenges and created a substantial economic burden. Korea has experienced an extensive outbreak, which was linked to a religion-related super-spreading event. However, the implementation of various non-pharmaceutical interventions (NPIs), including social distancing, spring semester postponing, and extensive testing and contact tracing controlled the epidemic. Herein, we estimated the effectiveness of each NPI using a simulation model. METHODS: A compartment model with a susceptible-exposed-infectious-quarantined-hospitalized structure was employed. Using the Monte-Carlo-Markov-Chain algorithm with Gibbs' sampling method, we estimated the time-varying effective contact rate to calibrate the model with the reported daily new confirmed cases from February 12th to March 31st (7 weeks). Moreover, we conducted scenario analyses by adjusting the parameters to estimate the effectiveness of NPI. RESULTS: Relaxed social distancing among adults would have increased the number of cases 27.4-fold until the end of March. Spring semester non-postponement would have increased the number of cases 1.7-fold among individuals aged 0-19, while lower quarantine and detection rates would have increased the number of cases 1.4-fold. CONCLUSION: Among the three NPI measures, social distancing in adults showed the highest effectiveness. The substantial effect of social distancing should be considered when preparing for the 2nd wave of COVID-19.


Assuntos
Controle de Doenças Transmissíveis/métodos , Busca de Comunicante/métodos , Infecções por Coronavirus/transmissão , Programas de Rastreamento/métodos , Pneumonia Viral/transmissão , Distância Social , Betacoronavirus , Simulação por Computador , Exposição Ambiental/prevenção & controle , Humanos , Cadeias de Markov , Modelos Teóricos , Método de Monte Carlo , Pandemias , Prática de Saúde Pública/legislação & jurisprudência , República da Coreia
8.
Cancer Control ; 27(1): 1073274820960471, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32938229

RESUMO

Early detection of cancer greatly increases the chances of better survival. The emergence of COVID-19 pandemic has disrupted several essential health services globally and early detection of cancer services is one of them. The routine cancer screenings have plummeted in many developed countries since the crisis. India has highest estimated lip and oral cavity cancer cases worldwide (119,992, 33.8%) and the secondhighest number of breast (162,468, 17.8%) and cervix uteri (96,922,30.7%) cancers in Asian sub-continent. Not only India has high burden of cancer, but the majority (75-80%) of patients have advanced disease at the time of diagnosis. Hence is it imperative that early detection services should be kept functional at out-patient settings so that at least the patients coming to hospitals with early signs and symptoms can be diagnosed as early as possible. Strategies need to be adopted to continue early detection services and ensure safety of patients and health care workers from COVID-19 transmission.


Assuntos
Infecções por Coronavirus/epidemiologia , Detecção Precoce de Câncer , Programas de Rastreamento/métodos , Neoplasias/diagnóstico , Pandemias , Pneumonia Viral/epidemiologia , Betacoronavirus , Infecções por Coronavirus/complicações , Humanos , Índia/epidemiologia , Neoplasias/complicações , Neoplasias/epidemiologia , Pneumonia Viral/complicações
10.
Sante Publique ; 32(1): 103-111, 2020.
Artigo em Francês | MEDLINE | ID: mdl-32985967

RESUMO

BACKGROUND: Outreach HIV testing strategies have significantly contributed to the increase in the number of people knowing their HIV status in sub-Saharan Africa. This article analyzes the articulation of donor and field constraints on the implementation of outreach HIV testing strategies in Côte d’Ivoire. METHODS: Qualitative research was conducted in three health districts (Man, Cocody-Bingerville and Aboisso) in Côte d’Ivoire in 2015-2016, through in-depth interviews with community providers, local leaders and people tested and through observation of outreach HIV testing activities. RESULTS: Implementing organizations feel “under pressure” to meet donors’ objectives that are deemed unattainable, as well as the lack of training and funding. As a result, providers do not observe systematically the rules of the “three Cs” (counselling, informed consent, confidentiality), and propose testing to individuals who are “off-target” (in terms of locations and populations). DISCUSSION: Implementing NGOs experience two types of constraints those resulting from the functioning of international aid (inadequate funding compared to actual costs, objectives too high, the important chain of intermediaries) and those related to the local context (spaces not adapted to guarantee confidentiality and the professional activity of target populations). CONCLUSION: The pressure that is exerted at different levels on implementing NGOs is detrimental to the quality of HIV testing. It is now essential to develop a more qualitative approach in defining strategies and evaluation criteria.


Assuntos
Agentes Comunitários de Saúde , Aconselhamento , Infecções por HIV/diagnóstico , Programas de Rastreamento/métodos , Serviços Preventivos de Saúde/organização & administração , Fortalecimento Institucional , Costa do Marfim , Infecções por HIV/prevenção & controle , Humanos , Entrevistas como Assunto , Pesquisa Qualitativa
11.
PLoS Med ; 17(9): e1003346, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32960881

RESUMO

BACKGROUND: There is disagreement about the level of asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We conducted a living systematic review and meta-analysis to address three questions: (1) Amongst people who become infected with SARS-CoV-2, what proportion does not experience symptoms at all during their infection? (2) Amongst people with SARS-CoV-2 infection who are asymptomatic when diagnosed, what proportion will develop symptoms later? (3) What proportion of SARS-CoV-2 transmission is accounted for by people who are either asymptomatic throughout infection or presymptomatic? METHODS AND FINDINGS: We searched PubMed, Embase, bioRxiv, and medRxiv using a database of SARS-CoV-2 literature that is updated daily, on 25 March 2020, 20 April 2020, and 10 June 2020. Studies of people with SARS-CoV-2 diagnosed by reverse transcriptase PCR (RT-PCR) that documented follow-up and symptom status at the beginning and end of follow-up or modelling studies were included. One reviewer extracted data and a second verified the extraction, with disagreement resolved by discussion or a third reviewer. Risk of bias in empirical studies was assessed with an adapted checklist for case series, and the relevance and credibility of modelling studies were assessed using a published checklist. We included a total of 94 studies. The overall estimate of the proportion of people who become infected with SARS-CoV-2 and remain asymptomatic throughout infection was 20% (95% confidence interval [CI] 17-25) with a prediction interval of 3%-67% in 79 studies that addressed this review question. There was some evidence that biases in the selection of participants influence the estimate. In seven studies of defined populations screened for SARS-CoV-2 and then followed, 31% (95% CI 26%-37%, prediction interval 24%-38%) remained asymptomatic. The proportion of people that is presymptomatic could not be summarised, owing to heterogeneity. The secondary attack rate was lower in contacts of people with asymptomatic infection than those with symptomatic infection (relative risk 0.35, 95% CI 0.10-1.27). Modelling studies fit to data found a higher proportion of all SARS-CoV-2 infections resulting from transmission from presymptomatic individuals than from asymptomatic individuals. Limitations of the review include that most included studies were not designed to estimate the proportion of asymptomatic SARS-CoV-2 infections and were at risk of selection biases; we did not consider the possible impact of false negative RT-PCR results, which would underestimate the proportion of asymptomatic infections; and the database does not include all sources. CONCLUSIONS: The findings of this living systematic review suggest that most people who become infected with SARS-CoV-2 will not remain asymptomatic throughout the course of the infection. The contribution of presymptomatic and asymptomatic infections to overall SARS-CoV-2 transmission means that combination prevention measures, with enhanced hand hygiene, masks, testing tracing, and isolation strategies and social distancing, will continue to be needed.


Assuntos
Infecções Assintomáticas/epidemiologia , Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Doenças Assintomáticas/epidemiologia , Betacoronavirus , Infecções por Coronavirus/fisiopatologia , Infecções por Coronavirus/transmissão , Progressão da Doença , Humanos , Programas de Rastreamento , Pandemias , Pneumonia Viral/fisiopatologia , Pneumonia Viral/transmissão , Reação em Cadeia da Polimerase Via Transcriptase Reversa
12.
Monaldi Arch Chest Dis ; 90(3)2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32885625

RESUMO

COVID-19 has been affecting mankind round the globe. The incidence of this infectious disease of respiratory origin is constantly on rise. Another infectious disease widely prevalent is tuberculosis (TB). During past corona virus pandemics of Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome, coinfection with TB was seen. We present this review as the co-infection of COVID-19 with TB has not been assessed yet, imposing a greater global threat. We suggest few measures to be implemented without delay for effectively screening the suspects of co-infection and also follow up of non-suspect patients in the post-pandemic phase.


Assuntos
Coinfecção , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Síndrome Respiratória Aguda Grave/complicações , Tuberculose Pulmonar/complicações , Infecções Assintomáticas , Betacoronavirus , Humanos , Programas de Rastreamento , Pandemias , Isolamento de Pacientes , Índice de Gravidade de Doença , Tuberculose Pulmonar/diagnóstico
13.
Cien Saude Colet ; 25(9): 3475-3480, 2020 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32876252

RESUMO

The study aims to identify marital violence precipitating/intensifying elements during the COVID-19 pandemic. This is a narrative review of the literature, and the search was carried out in May 2020. We employed the PubCovid-19 platform, which is indexed in the United States National Library of Medicine (PubMed) and the Excerpta Medica (EMBASE) database. English descriptors "Domestic violence", "COVID-19", and "Intimate Partner Violence" were used in the search, and nine papers were selected for full-text reading. Three empirical categories were elaborated from the exploration of the selected material: Economic instability, Alcohol and other drugs use/abuse, and Weaker women's support network. Support networks for women in situations of marital violence should be expanded in this pandemic context, with emphasis on the use of digital technologies as possible tools for screening pandemic-related violence cases.


Assuntos
Infecções por Coronavirus/epidemiologia , Programas de Rastreamento/métodos , Pneumonia Viral/epidemiologia , Maus-Tratos Conjugais/estatística & dados numéricos , Consumo de Bebidas Alcoólicas/epidemiologia , Feminino , Humanos , Masculino , Pandemias , Fatores de Risco , Transtornos Relacionados ao Uso de Substâncias/epidemiologia
14.
Cien Saude Colet ; 25(9): 3445-3458, 2020 Sep.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32876277

RESUMO

An infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the 2019 Novel Coronavirus Disease (COVID-19) pandemic has unveiled a hitherto hidden reality: the vulnerability of the population living in long-term care facilities for the elderly (LTCF). To date, several scientific publications have revealed a concentration of up to 60% of deaths attributed to COVID-19 in such institutions. Most LTFC residents share the primary risk factors currently associated with increased morbimortality due to the COVID-19 infection. It is crucial to define actions to prevent SARS-CoV-2 spread in this environment, besides the usual measures of social distancing and isolation of the carriers of this disease. This paper proposes strategies for the investigation of this infection in LTCF residents and workers using laboratory tests available in Brazil. The early identification of individuals with SARS-CoV-2, who may actively and continuously spread the virus, allows adopting measures aimed at interrupting the local transmission cycle of this infection.


Assuntos
Técnicas de Laboratório Clínico , Infecções por Coronavirus/epidemiologia , Instituição de Longa Permanência para Idosos/estatística & dados numéricos , Programas de Rastreamento/métodos , Pneumonia Viral/epidemiologia , Idoso , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/mortalidade , Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde , Humanos , Assistência de Longa Duração , Pandemias/prevenção & controle , Pneumonia Viral/mortalidade , Pneumonia Viral/prevenção & controle , Populações Vulneráveis
15.
Psychiatr Danub ; 32(Suppl 1): 146-149, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32890379

RESUMO

BACKGROUND: In Belgium, 82% of the population consumes alcohol occasionally while 10% consume in a way that can be seen as problematic. On a European level, only 8% of the people who can be characterized as having Alcohol Use Disorder (AUD) would have consulted professional assistance in the past year. In this context, the KCE (Belgian Health Care Knowledge Centre) has addressed multiple recommendations to health professionals to reduce the "treatment gap" concerning the patients' care: (1) encourage screening and preventative interventions, (2) promote the acquirement of communicational and relational competences (3) develop collaborations between professionals. The objective of this article is to better understand their functioning. METHOD: We format a non-systematic literature review concerning these recommendations. RESULTS: The implementation of these Brief Interventions programs in primary care is relevant due to the moderately positive impact on the frequency and quantity of alcohol consumption but both the quality of the therapeutic relationship and collaboration with the care network would optimize Brief Interventions. The quality of the therapeutic relationship alone appears to have an impact on therapeutic outcome. CONCLUSION: Training concerning patient-professional relationship is necessary to maximize the effectiveness of BIs.


Assuntos
Consumo de Bebidas Alcoólicas , Alcoolismo , Atenção Primária à Saúde , Alcoolismo/diagnóstico , Bélgica , Humanos , Programas de Rastreamento
16.
Artigo em Inglês | MEDLINE | ID: mdl-32899619

RESUMO

Keeping the dynamic nature of Coronaviruses (COVID-19) pandemic in mind, we have opted to explore the importance of the decentralization of COVID-19 testing centers across the country of Bangladesh in order to combat the pandemic. In doing so, we considered quantitative, qualitative, and geographic information systems (GIS) datasets to identify the location of existing COVID-19 testing centers. Moreover, we attempted to collect data from the existing centers in order to demonstrate testing times at the divisional level of the country. Results show that the number of testing centers is not enough to cater to the vast population of the country. Additionally, we found that the number of days it takes to receive the results from the COVID-19 testing centers is not optimal at divisional cities, let alone the remote rural areas. Finally, we propose a set of recommendations in order to enhance the existing system to assist more people under a testing range of COVID-19 viruses at the local level.


Assuntos
Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Programas de Rastreamento/organização & administração , Pneumonia Viral/diagnóstico , Bangladesh/epidemiologia , Betacoronavirus , Sistemas de Informação Geográfica , Humanos , Pandemias
17.
Acta Biomed ; 91(3): e2020009, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32921707

RESUMO

BACKGROUND: In Italy, one of the country most affected by the COVID-19 pandemic, the first autochthonous case appeared in Lombardy on February 20th, 2020. One month later, the number of -COVID-19 patients in Lombardy exceeded 17000 and about 3500 had died. Because of this rapid increase in infected people scientists wonder whether SARS-CoV-2 was already highly circulating in Lombardy before such date. Plasma levels of aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were shown to be -highly increased in COVID-19 patients. Monitoring their levels in Emergency Room patients during the months preceding February 20th, 2020, might shade light on the prevalence of the disease in the pre-COVID-19 period. METHODS: We retrospectively analyzed the AST and LDH levels from more than 30.000 patients admitted to the San Raffaele Hospital Emergency Room (ER) between September 2019 and May 2020 as well as between September 2018 and May 2019. The number of patients diagnosed with respiratory tract diseases were also analyzed. RESULTS: Data showed that the ER averaged AST and LDH levels are highly sensitive to the presence of COVID-19 patients. During, the months preceding February 20th, 2020, AST and LDH levels, as well as the number of patients diagnosed with respiratory tract diseases were similar to their 2019 counterparts. CONCLUSIONS: No significant evidence showing that a large number of COVID-19 patients were admitted to the San Raffaele Hospital ER before February 20th, 2020, was found. Thus, the virus was likely circulating, within the Hospital catchment area, either in low amounts or through asymptomatic individuals. Because of the high LDH and AST levels' variations induced by COVID-19, routine blood tests might be exploited as a surveillance indicator for a possible second wave.


Assuntos
Betacoronavirus , Infecções por Coronavirus/diagnóstico , Testes Hematológicos/métodos , Programas de Rastreamento/métodos , Monitorização Fisiológica/métodos , Pandemias , Pneumonia Viral/diagnóstico , Aspartato Aminotransferases/sangue , Biomarcadores/sangue , Infecções por Coronavirus/sangue , Infecções por Coronavirus/epidemiologia , Feminino , Humanos , Itália/epidemiologia , L-Lactato Desidrogenase/sangue , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/sangue , Pneumonia Viral/epidemiologia , Prevalência , Estudos Retrospectivos
18.
Artigo em Inglês | MEDLINE | ID: mdl-32933172

RESUMO

BACKGROUND: The Saudi government has taken the decision to prevent the entrance of about 2.5 million international pilgrims seeking to perform hajj in order to protect the world from a catastrophic widespread of disease. Moreover, health systems in Saudi Arabia are offering free testing for residents whether Saudi and non-Saudi. OBJECTIVE: This study aimed to evaluate the spread of COVID-19 associated with preventive measures taken in Saudi Arabia and to develop a detailed COVID-19 prevention strategy as a framework for the Saudi Arabia community. METHODOLOGY: Population size and age distributions among the country of Saudi Arabia were taken from the 2020 World Population Prospects. Contact patterns were measured using the Saudi Arabia Ministry of Health Statistical Annual Report. CONCLUSIONS: Our study demonstrates that performing screening tests as early as possible to facilitate the rapid detection of infected cases, fast treatment, and instant isolation for suspected cases is the most definitive rejoinder for public health. Moreover, our study revealed the significance of performing preventive measures in reducing infection and death rates around Saudi Arabia by 27%, while in other countries, it reduced the death rate ranging from 10-73%. This study provides an achievable strategy for prevention and early detection of COVID-19 spread.


Assuntos
Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Programas de Rastreamento , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Betacoronavirus , Humanos , Islamismo , Quarentena , Arábia Saudita/epidemiologia
19.
Clin Imaging ; 67: 219-225, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32871426

RESUMO

Since first report of a novel coronavirus in December of 2019, the Coronavirus Disease 2019 (COVID-19) pandemic has crippled healthcare systems around the world. While many initial screening protocols centered around laboratory detection of the virus, early testing assays were thought to be poorly sensitive in comparison to chest computed tomography, especially in asymptomatic disease. Coupled with shortages of reverse transcription polymerase chain reaction (RT-PCR) testing kits in many parts of the world, these regions instead turned to the use of advanced imaging as a first-line screening modality. However, in contrast to previous Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome coronavirus epidemics, chest X-ray has not demonstrated optimal sensitivity to be of much utility in first-line screening protocols. Though current national and international guidelines recommend for the use of RT-PCR as the primary screening tool for suspected cases of COVID-19, institutional and regional protocols must consider local availability of resources when issuing universal recommendations. Successful containment and social mitigation strategies worldwide have been thus far predicated on unified governmental responses, though the underlying ideologies of these practices may not be widely applicable in many Western nations. As the strain on the radiology workforce continues to mount, early results indicate a promising role for the use of machine-learning algorithms as risk stratification schema in the months to come.


Assuntos
Técnicas de Laboratório Clínico/métodos , Controle de Doenças Transmissíveis/métodos , Infecções por Coronavirus/diagnóstico , Saúde Global , Programas de Rastreamento/métodos , Pandemias , Pneumonia Viral/diagnóstico , Ásia , Betacoronavirus , Coronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/virologia , Europa (Continente) , Humanos , América do Norte , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/virologia , Reação em Cadeia da Polimerase/métodos , Estudos Retrospectivos , Tomografia Computadorizada por Raios X/métodos
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