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1.
Am Fam Physician ; 103(4): 209-217, 2021 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-33587575

RESUMO

Health maintenance for women of reproductive age includes counseling and screening tests that have been demonstrated to prevent disease and improve health. This article focuses mainly on conditions that are more common in women or have a unique impact on female patients. Family physicians should be familiar with evidence-based recommendations for contraception and preconception care and should consider screening patients for pregnancy intention. The American Academy of Family Physicians recommends against screening pelvic examinations in asymptomatic women; the U.S. Preventive Services Task Force (USPSTF) found insufficient evidence to make a recommendation for or against screening pelvic examinations. The USPSTF recommendations for women in this age group include screening for obesity and other cardiovascular risk factors, depression, intimate partner violence, cervical cancer, HIV, hepatitis C virus, tobacco use, and unhealthy alcohol and drug use as part of routine primary care. Breast cancer screening with mammography is recommended for women 50 years and older and should be individualized for women 40 to 49 years of age, although other organizations recommend earlier screening. Screening for sexually transmitted infections is based on age and risk factors; women younger than 25 years who are sexually active should be screened routinely for gonorrhea and chlamydia, whereas screening for syphilis and hepatitis B virus should be individualized. Immunizations should be recommended according to guidelines from the Centers for Disease Control and Prevention and the Advisory Committee on Immunization Practices; immunizations against influenza; tetanus; measles, mumps, and rubella; varicella; meningococcus; and human papillomavirus are of particular importance in women of reproductive age. To have the greatest impact on health, physicians should focus on USPSTF grade A and B recommendations with patients.


Assuntos
Detecção Precoce de Câncer/normas , Prática Clínica Baseada em Evidências/normas , Guias de Prática Clínica como Assunto , Serviços Preventivos de Saúde/normas , Reprodução , Serviços de Saúde da Mulher/normas , Saúde da Mulher , Adulto , Currículo , Educação Médica Continuada , Feminino , Humanos , Gravidez , Fatores de Risco , Estados Unidos
7.
Ned Tijdschr Geneeskd ; 1652020 12 15.
Artigo em Holandês | MEDLINE | ID: mdl-33332034

RESUMO

The Dutch test capacity to detect the SARS-CoV-2 virus has increased enormously since the start of the COVID-19 pandemic. As a consequence of ongoing spreading of the virus, tests are also increasingly being carried out among people without COVID-19 related symptoms. Preventive testing for SARS-CoV-2 is especially performed in sectors in which early detection of the virus is essential, for instance in the professional sports sector. The guideline of the RIVM states that people who have tested positive for SARS-CoV-2 but without COVID-19 related symptoms are advised to stay in isolation for five days from time of the test. However, this guideline is not suitable for people who are diagnosed in a very early stage of the infection as a result of preventive testing. They are likely to leave isolation during the most contagious phase of the infection. In this paper, we argue that people who are positive for SARS-CoV-2, but without COVID-19 related symptoms, after a preventive test should be advised to isolate longer than five days.


Assuntos
/métodos , Controle de Doenças Transmissíveis/métodos , /isolamento & purificação , /diagnóstico , Diagnóstico Precoce , Humanos , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/normas , Fatores de Tempo
8.
J Fam Pract ; 69(10): 514-517, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33348347

RESUMO

The new draft recommendations from the US Preventive Services Task Force make a significant change to the previous colorectal cancer screening recommendations. This month, Dr. Campos-Outcalt describes that change and provides a look at the financial implications (as stipulated by the Affordable Care Act) of the screening method chosen.


Assuntos
Neoplasias Colorretais/diagnóstico , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/prevenção & controle , Medicina de Família e Comunidade/normas , Programas de Rastreamento/normas , Guias de Prática Clínica como Assunto , Serviços Preventivos de Saúde/normas , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos/epidemiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-33327586

RESUMO

Primary hypertension (HTN) and obesity are associated with a worse health-related quality of life (QoL). This research was carried out to analyze the health-related QoL measurements in a physically inactive and obese population with HTN (n = 253) in comparison to a HEALTHY sample (n = 30), to determine the HTN sample changes in QoL following different (high-volume moderate-intensity continuous training, high-volume high-intensity interval training (HIIT), low-volume HIIT) 16-week supervised aerobic exercise training (ExT) programs compared to attention control, and to assess the differences in QoL variables between the different ExT programs. The SF-36 questionnaire was used to assess health-related QoL. At baseline, HTN showed lower scores (p < 0.05) in physical function (88.6 vs. 99.2), general health (63.3 vs. 82.4), vitality (58.2 vs. 68.7), social functioning (88.5 vs. 95.2), and mental health (76.1 vs. 81.8) compared to HEALTHY. Following intervention, all HTN subgroups showed higher (p < 0.05) vitality, but physical functioning and general health significantly improved only in the ExT groups, with even better values in general health for both HIIT subgroups. Only the low-volume HIIT showed positive changes (p < 0.05) in social functioning (∆ = 6.9%) and mental health (∆ = 6.4%) domains after the intervention. These results highlight the important role of supervised exercise in improving physical and psychological health.


Assuntos
Exercício Físico , Hipertensão , Obesidade , Sobrepeso , Serviços Preventivos de Saúde , Qualidade de Vida , Adulto , Estudos Transversais , Feminino , Treinamento Intervalado de Alta Intensidade , Humanos , Hipertensão/terapia , Masculino , Pessoa de Meia-Idade , Obesidade/terapia , Sobrepeso/terapia , Serviços Preventivos de Saúde/normas , Resultado do Tratamento
10.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi ; 32(5): 498-501, 2020 Jul 29.
Artigo em Chinês | MEDLINE | ID: mdl-33185061

RESUMO

OBJECTIVE: To investigate the prevalence of Schistosoma japonicum infections in Elaphurus davidianus released to Poyang Lake areas and evaluate the impact of the project of "E. davidianus released to wild environments for natural reproduction and growth" "(E. davidianus return home project") on the transmission of schistosomiasis in Poyang Lake areas. METHODS: During the period from April 2018 to December 2019, the population distribution, inhabiting activity and natural reproduction of E. davidianus released to Poyang Lake areas were investigated by means of GPS and artificial observations. The S. japonicum infection was identified in animal feces in E. davidianus inhabitats using a hatching test, and snail distribution was surveyed in E. davidianus inhabiting grass islands using a systematic sampling method. RESULTS: A total of 51 E. davidianus were released to the Poyang Lake areas in 2018, which subsequently produced 5 E. davidianus habitats in Yinlong Lake, Longkou, Nanchi Lake, Lianzi Lake and Zhu Lake. E. davidianus was found to predominantly inhibit in grass islands, farmlands and forest lands in hilly regions around the Poyang Lake areas. The natural reproduction rate of E. davidianus was 25% in the habitats in 2019, and the mean density of snails was 0.009 to 0.039 snails/0.1 m2 in E. davidianus inhabitats; however, no S. japonicum infection was identified in snails. In addition, the mean densities of wild E. davidianus and bovine feces were 4.6 samples/hm2 and 2.1 samples/hm2, Conclusions The E. davidianus released to Poyang Lake areas may get infections with S. japonicum, and cause schistosomiasis transmission through fecal contamination in grass islands. The impact on and the prevalence of S. japonicum infection was 4.35% and 13.16% (P = 0.236), respectively; however, the intensities of S. japonicum infections were "+++" and "+", respectively. CONCLUSIONS: The E. davidianus released to Poyang Lake areas may get infections with S. japonicum, and cause schistosomiasis transmission through fecal contamination in grass islands. The impact on local schistosomiasis transmission and the response strategy requires to be investigated following the release of E. davidianus to lake regions, to ensure the achievement of the goal of schistosomiasis elimination and the successful implementation of the "E. davidianus return home project" in Poyang Lake areas.


Assuntos
Lagos , Serviços Preventivos de Saúde , Esquistossomose Japônica , Animais , Bovinos , China/epidemiologia , Ecossistema , Fezes/parasitologia , Pradaria , Prevalência , Serviços Preventivos de Saúde/normas , Esquistossomose Japônica/epidemiologia , Esquistossomose Japônica/prevenção & controle , Esquistossomose Japônica/transmissão
12.
Sensors (Basel) ; 20(17)2020 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-32887338

RESUMO

COVID-19 has shown a relatively low case fatality rate in young healthy individuals, with the majority of this group being asymptomatic or having mild symptoms. However, the severity of the disease among the elderly as well as in individuals with underlying health conditions has caused significant mortality rates worldwide. Understanding this variance amongst different sectors of society and modelling this will enable the different levels of risk to be determined to enable strategies to be applied to different groups. Long-established compartmental epidemiological models like SIR and SEIR do not account for the variability encountered in the severity of the SARS-CoV-2 disease across different population groups. The objective of this study is to investigate how a reduction in the exposure of vulnerable individuals to COVID-19 can minimise the number of deaths caused by the disease, using the UK as a case study. To overcome the limitation of long-established compartmental epidemiological models, it is proposed that a modified model, namely SEIR-v, through which the population is separated into two groups regarding their vulnerability to SARS-CoV-2 is applied. This enables the analysis of the spread of the epidemic when different contention measures are applied to different groups in society regarding their vulnerability to the disease. A Monte Carlo simulation (100,000 runs) along the proposed SEIR-v model is used to study the number of deaths which could be avoided as a function of the decrease in the exposure of vulnerable individuals to the disease. The results indicate a large number of deaths could be avoided by a slight realistic decrease in the exposure of vulnerable groups to the disease. The mean values across the simulations indicate 3681 and 7460 lives could be saved when such exposure is reduced by 10% and 20% respectively. From the encouraging results of the modelling a number of mechanisms are proposed to limit the exposure of vulnerable individuals to the disease. One option could be the provision of a wristband to vulnerable people and those without a smartphone and contact-tracing app, filling the gap created by systems relying on smartphone apps only. By combining very dense contact tracing data from smartphone apps and wristband signals with information about infection status and symptoms, vulnerable people can be protected and kept safer.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Transmissão de Doença Infecciosa/estatística & dados numéricos , Modelos Teóricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Saúde Pública/métodos , Quarentena/organização & administração , Populações Vulneráveis , Busca de Comunicante/métodos , Infecções por Coronavirus/epidemiologia , Surtos de Doenças/prevenção & controle , Diretrizes para o Planejamento em Saúde , Necessidades e Demandas de Serviços de Saúde , Humanos , Controle de Infecções/métodos , Controle de Infecções/organização & administração , Controle de Infecções/estatística & dados numéricos , Invenções/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Serviços Preventivos de Saúde/normas , Saúde Pública/estatística & dados numéricos , Administração em Saúde Pública/métodos , Quarentena/métodos , Quarentena/estatística & dados numéricos , Reino Unido/epidemiologia , Populações Vulneráveis/estatística & dados numéricos
14.
Obstet Gynecol ; 136(4): 657-662, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32925626

RESUMO

The maternal mortality ratio in the United States is increasing; understanding the significance of this change and developing effective responses requires a granular analysis of the contributing factors that a well-informed maternal mortality review committee can provide. Data collection and analysis, clinical factors, preventability, social determinants of health, and racial inequities combine to affect this outcome, and each factor must be considered individually and in combination to recommend a robust response. Obstetrician-gynecologists formed the State of Michigan's Maternal Mortality Review Committee (the Committee) in 1950 to identify gaps in care that needed to be systematically addressed at the time. In the early years, the Committee witnessed a reduction in the number of maternal deaths; over time, prioritization of maternal mortality decreased, yet the Committee witnessed changing patterns of death, varied data collection and evaluation processes, delayed reviews, and unimplemented recommendations. The calculation of the maternal mortality ratio was not informed by the outcomes of Committee reviews. Today, the Committee, with increased support from the Michigan Department of Health & Human Services, can clearly identify and report preventable pregnancy-related mortality along with its causes and is close to achieving a near real-time surveillance system that allows the development of timely clinical and policy recommendations and interventions. The Committee's adaptations in response to the rise in maternal mortality have resulted in several lessons learned that may be helpful for currently operating committees and in the formation of new ones.


Assuntos
Uso Indevido de Medicamentos , Mortalidade Materna/tendências , Complicações na Gravidez , Serviços Preventivos de Saúde , Melhoria de Qualidade , Suicídio , Adulto , Comitês Consultivos/normas , Comitês Consultivos/estatística & dados numéricos , Uso Indevido de Medicamentos/mortalidade , Uso Indevido de Medicamentos/prevenção & controle , Falha da Terapia de Resgate/estatística & dados numéricos , Feminino , Disparidades em Assistência à Saúde/normas , Humanos , Michigan/epidemiologia , Mortalidade , Gravidez , Complicações na Gravidez/mortalidade , Complicações na Gravidez/prevenção & controle , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/normas , Melhoria de Qualidade/organização & administração , Melhoria de Qualidade/tendências , Determinantes Sociais da Saúde/etnologia , Suicídio/prevenção & controle , Suicídio/estatística & dados numéricos
15.
Trends Parasitol ; 36(10): 826-834, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32819826

RESUMO

The presentation of cysticercosis is very heterogeneous both between and within countries. Several host and parasite factors are involved in this heterogeneity. Differences in the intensity of infection pressure have not been studied thus far. We have compiled data that could demonstrate that differences in infection pressure are involved in the still high prevalence of parenchymal neurocysticercosis and ocular cysticercosis in some countries (which have a stable infection pressure) and in the high proportion of extraparenchymal neurocysticercosis in others (which have had a progressive decrease in infection pressure). Therefore, the distribution of clinicoradiological forms of cysticercosis could be a marker of the intensity of infection pressure and could help to determine in which countries control programs should be a priority.


Assuntos
Cisticercose/epidemiologia , Animais , Cisticercose/parasitologia , Cisticercose/prevenção & controle , Transmissão de Doença Infecciosa , Humanos , Prevalência , Serviços Preventivos de Saúde/normas
16.
High Blood Press Cardiovasc Prev ; 27(5): 373-377, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32734561

RESUMO

In 2020, the Sars-Cov-2 pandemic is causing a huge and dramatic impact on healthcare systems worldwide. During this emergency, fragile patients suffering from other comorbidities, especially patients susceptible to or affected by cardiovascular disease, are the ones most exposed to the poorer outcomes. Therefore, it is still mandatory to continue to strictly adhere to the rules of cardiovascular prevention. This document aims to provide all doctors with simple and clear recommendations in order to spread useful messages to the widest number of subjects in order to continue the battle against cardiovascular diseases even in times of pandemic.


Assuntos
Betacoronavirus/patogenicidade , Cardiologia/normas , Fármacos Cardiovasculares/uso terapêutico , Doenças Cardiovasculares/prevenção & controle , Infecções por Coronavirus/terapia , Pneumonia Viral/terapia , Serviços Preventivos de Saúde/normas , Comportamento de Redução do Risco , Fármacos Cardiovasculares/efeitos adversos , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Consenso , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Interações Hospedeiro-Patógeno , Humanos , Pandemias , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Medição de Risco , Fatores de Risco
17.
Rev Chilena Infectol ; 37(1): 9-18, 2020 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-32730394

RESUMO

BACKGROUND: Antimicrobial Stewardship Programs (ASP) focus in the appropriate use of antimicrobials to improve clinical results and minimize risk of adverse events. AIMS: To compare consumption and costs of antimicrobials before and after the establishment of an antimicrobial stewardship program and to describe the resistance proportion of priority bacteria. METHODS: Quasi-experimental, retrospective and prospective, descriptive and analytical study, to compare consumption and costs of antimicrobials in a pre- intervention period (2007-2010) and a post- intervention period (2011-2017). Additionally, a descriptive analysis of bacterial resistance from 2010 was performed. RESULTS: Gentamicin, vancomycin, meropenem, cefotaxime, ceftazidime and imipenem consumption decreased significantly in the post-intervention period compared to the pre-intervention period (p < 0.05) while consumption of amikacin, piperacillin/tazobactam, cefepime and levofloxacin increased significantly in the post-intervention period. The reduction in costs was not significant for gentamicin, vancomycin, meropenem, cefotaxime, ceftazidime and imipenem, meanwhile, costs increased for amikacin, piperacillin/tazobactam, cefepime and levofloxacin, but this was not significant. The isolation of Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Enterococcus faecalis decreased during the post-intervention period. CONCLUSION: The ASP showed a decrease in consumption and costs of some antimicrobials.


Assuntos
Antibacterianos , Gestão de Antimicrobianos , Infecções Bacterianas , Serviços Preventivos de Saúde , Antibacterianos/economia , Antibacterianos/uso terapêutico , Gestão de Antimicrobianos/economia , Gestão de Antimicrobianos/normas , Gestão de Antimicrobianos/estatística & dados numéricos , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/prevenção & controle , Criança , Hospitais Pediátricos/economia , Hospitais Pediátricos/estatística & dados numéricos , Humanos , Testes de Sensibilidade Microbiana , Panamá , Serviços Preventivos de Saúde/economia , Serviços Preventivos de Saúde/normas , Serviços Preventivos de Saúde/estatística & dados numéricos , Estudos Prospectivos , Estudos Retrospectivos
18.
Curr Res Transl Med ; 68(3): 111-118, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32620465

RESUMO

The pandemic of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly across the world. Currently, the COVID-19 pandemic is affecting the continuity of essential routine healthcare services and procedures, including chimeric antigen receptor T-cell (CAR-T) therapy, a life-saving option for patients with relapsed/refractory (R/R) hematologic malignancies. Due to the rapid disease progression of hematological malignancies, there is an urgent need to manufacture and utilize CAR T-cells. However, CAR-T treatment has become extraordinarily challenging during this COVID-19 pandemic. Thus, many medical and technical factors must now be taken into consideration before, during, and after CAR-T therapy. The purpose of this review is to provide brief suggestions for rational decision-making strategies in evaluating and selecting CAR T-cell treatment and appropriate CAR T-cell products, and protective strategies for medical staff and patients to prevent infection in the midst of the current COVID-19 pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Assistência à Saúde/organização & administração , Neoplasias Hematológicas/terapia , Imunoterapia Adotiva , Controle de Infecções/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Receptores de Antígenos de Linfócitos T/imunologia , Betacoronavirus/fisiologia , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/métodos , Assistência à Saúde/normas , Assistência à Saúde/tendências , Neoplasias Hematológicas/epidemiologia , Humanos , Imunoterapia Adotiva/métodos , Imunoterapia Adotiva/tendências , Controle de Infecções/métodos , Controle de Infecções/normas , Controle de Infecções/tendências , Pneumonia Viral/epidemiologia , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/organização & administração , Serviços Preventivos de Saúde/normas , Serviços Preventivos de Saúde/tendências
20.
Rev Bras Enferm ; 73Suppl 2(Suppl 2): e20200303, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32609251

RESUMO

OBJECTIVE: to discuss the application of Rapid Cycle Deliberate Practice for attire and unattire training in the context of COVID-19 and structure a practical guide to the application at this juncture. METHODS: this methodological study described theoretical and practical aspects of the application of a simulation strategy as a technological training tool. An application guide was constructed from the search for evidence from the main health authority bodies in Brazil. RESULTS: maximizing time in Deliberate Practice, feedback with evidence and psychological security are the principles of this strategy. The dynamic involves repetition and feedback. The application guide presents the sequence of actions for attire and unattire. FINAL CONSIDERATIONS: coping with this pandemic requires appropriate use of personal protective equipment. The authors suggest the Rapid Cycle Deliberate Practice as a technological educational tool for attire/unattire, since it encourages mastery performance.


Assuntos
Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde/educação , Pandemias/prevenção & controle , Equipamento de Proteção Individual/normas , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Serviços Preventivos de Saúde/normas , Adulto , Betacoronavirus , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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