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2.
Sleep Med Clin ; 15(3S): e1-e7, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-33008491

RESUMO

Prior to the COVID-19 pandemic, few pediatric sleep medicine clinicians routinely engaged in telemedicine visits because thorough examinations were difficult to perform; there was lack of consistent reimbursement; and many clinicians were busy with their in-office practices. This article reviews how telemedicine has been explored in pediatric sleep medicine prior to the pandemic, current applications of telemedicine, challenges, and reimagining pediatric sleep within the realm of telemedicine.


Assuntos
Pediatria , Medicina do Sono , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/terapia , Telemedicina/métodos , Betacoronavirus , Criança , Pressão Positiva Contínua nas Vias Aéreas , Infecções por Coronavirus , Humanos , Otolaringologia , Pandemias , Pneumonia Viral , Polissonografia , Encaminhamento e Consulta , Síndrome das Pernas Inquietas/diagnóstico , Síndrome das Pernas Inquietas/terapia , Sono , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/terapia , Transtornos do Sono do Ritmo Circadiano/diagnóstico , Transtornos do Sono do Ritmo Circadiano/terapia , Distúrbios do Início e da Manutenção do Sono/diagnóstico , Distúrbios do Início e da Manutenção do Sono/terapia
4.
Cancer Control ; 27(1): 1073274820964800, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33023342

RESUMO

Emergence of the COVID-19 crisis has catalyzed rapid paradigm shifts throughout medicine. Even after the initial wave of the virus subsides, a wholesale return to the prior status quo is not prudent. As a specialty that values the proper application of new technology, radiation oncology should strive to be at the forefront of harnessing telehealth as an important tool to further optimize patient care. We remain cognizant that telehealth cannot and should not be a comprehensive replacement for in-person patient visits because it is not a one for one replacement, dependent on the intention of the visit and patient preference. However, we envision the opportunity for the virtual patient "room" where multidisciplinary care may take place from every specialty. How we adapt is not an inevitability, but instead, an opportunity to shape the ideal image of our new normal through the choices that we make. We have made great strides toward genuine multidisciplinary patient-centered care, but the continued use of telehealth and virtual visits can bring us closer to optimally arranging the spokes of the provider team members around the central hub of the patient as we progress down the road through treatment.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Neoplasias/diagnóstico , Aceitação pelo Paciente de Cuidados de Saúde , Quartos de Pacientes/organização & administração , Pneumonia Viral/epidemiologia , Telemedicina/métodos , Realidade Virtual , Comorbidade , Humanos , Neoplasias/epidemiologia , Pandemias , Satisfação do Paciente
6.
BMJ Case Rep ; 13(10)2020 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-33012707

RESUMO

This is a report of the first three cases of endovascular aneurysm treatment that were proctored by a remote interventionalist using a novel high-resolution low-latency streaming technology. The proctor was located in a neurovascular centre and supported the treating interventional teams in two distant cities (up to 800 km/500 miles apart). All aneurysms were treated using the Woven EndoBridge (WEB) embolisation system, either electively or following subarachnoid haemorrhage. On-site proctoring was not possible due to travel restrictions during the COVID-19 pandemic. WEB placement was feasible in all cases. Good rapport between proctors and treating physicians was reported, enabled by the high-resolution image transmission and uninterrupted feedback/discussion via audiostream. No clinical complications were encountered. Short-term follow-up revealed adequate occlusion of all treated aneurysms. The employed streaming technology provided effective remote proctoring during complex aneurysm cases, including the management of technical complications.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Procedimentos Endovasculares/métodos , Aneurisma Intracraniano/terapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Telemedicina/métodos , Angiografia Digital/métodos , Humanos , Aneurisma Intracraniano/diagnóstico por imagem
8.
Acta Biomed ; 91(3): ahead of print, 2020 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-32921744

RESUMO

During the COVID-19 pandemic, surgical elective procedures were stopped in our plastic surgery unit. Limitations for consultations and for follow-up of previous surgical procedures were imposed in order to minimize the risk of contagion in waiting rooms and outpatient clinics. We have identified telemedicine as an alternative way to follow patients during the lockdown. Nevertheless, we have experienced different difficulties. We have not had the possibility to use a secure teleconferencing software. In our unit we had not technological devices. Surgeons in our department were not able to use remote video technology for patient management. Guidelines for an appropriate selection of patients which could be served via telemedicine had to be created. Telemedicine must be regulated by healthcare organizations for legal, ethical, medico-legal and risk management aspects. Even if we have experienced an important need to use telematic solutions during the COVID-19 lockdown, liability and risk management issues has greatly limited this possibility in our unit. The need of telemedicine in the time of COVID-19 pandemic has encouraged us to implement future virtual encounters in order to reduce unnecessary in-person visits by taking into consideration all legal, ethical and medico-legal aspects.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Pneumonia Viral/epidemiologia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Gestão de Riscos/métodos , Cirurgia Plástica/organização & administração , Telemedicina/métodos , Infecções por Coronavirus/transmissão , Humanos , Pandemias , Pneumonia Viral/transmissão
9.
Oncology (Williston Park) ; 34(9): 377-378, 2020 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-32965670

RESUMO

The telehealth explosion was facilitated by the onset of the coronavirus disease 2019 (COVID-19) pandemic, but what happens when the crisis is over? Will there be lasting changes to the practice of medicine and delivery of care, or will providers and patients alike be eager to go back to the "old way" of doing things? Jeremy Gabrysch, MD, a physician and CEO of Remedy, an on-demand urgent care service that delivers doctors right to your front door, discusses what the future of telehealth may hold.


Assuntos
Assistência à Saúde , Mecanismo de Reembolso , Padrão de Cuidado , Telemedicina/tendências , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Telemedicina/economia , Telemedicina/métodos , Telemedicina/normas
10.
Syst Rev ; 9(1): 217, 2020 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-32967717

RESUMO

BACKGROUND: COVID-19 has resulted in an increased demand for eHealth services globally. There is emerging evidence for the efficacy for group eHealth interventions that support population-based mental health and wellbeing, but a systematic review is lacking. The primary objective of this systematic review is to summarize the evidence for eHealth group counseling and coaching programs for adults. A second objective is to assess, within studies selected for our primary objective, the impact of programs that encourage PA on outcomes compared to those that do not. METHODS: Randomized controlled trials that assess the impact of eHealth group counseling or coaching programs on mental health, health behavior, or physical health activity among community-dwelling adults will be included. We will search the following electronic databases (from January 2005 onwards): MEDLINE, PsycINFO, CINHAL, and the Central Register of Controlled Trials. The primary outcomes will be changes in mental health conditions (e.g., depression, anxiety, stress, quality of life), behavioral health conditions (e.g., substance use, smoking, sexual behavior, eating behavior, medication adherence), and physical health conditions (e.g., coping with cancer, menopausal symptoms, arthritis pain). Secondary outcomes will be changes in physical activity. Two reviewers will independently screen all citations, full-text articles, and abstract data. Potential conflicts will be resolved through discussion with a third reviewer. A narrative synthesis without meta-analysis will be conducted. The strength of the body of evidence will be assessed using GRADE. The risk of bias in individual studies will be appraised using the Cochrane Risk of Bias 2.0 tool. Potential sources of gender bias in included studies will be considered at all stages of the planned review. DISCUSSION: This review will contribute to the literature by providing evidence on the effectiveness of eHealth counseling and coaching programs delivered to adults in a group format. SYSTEMATIC REVIEW REGISTRATION: The protocol has been registered at the International Prospective Register of Systematic Reviews (PROSPERO: CRD42020187551 ).


Assuntos
Assistência à Saúde , Exercício Físico , Nível de Saúde , Saúde Mental , Telemedicina/métodos , Adulto , Betacoronavirus , Infecções por Coronavirus , Aconselhamento/métodos , Humanos , Tutoria/métodos , Pandemias , Pneumonia Viral , Psicoterapia de Grupo/métodos
13.
Environ Health Prev Med ; 25(1): 48, 2020 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-32891113

RESUMO

BACKGROUND: In the wake of the coronavirus disease 2019 (COVID-19) pandemic, people need to practice social distancing in order to protect themselves from SARS-CoV-2 infection. In such stressful situations, remote cardiac rehabilitation (CR) might be a viable alternative to the outpatient CR program. METHODS: We prospectively investigated patients hospitalized for heart failure (HF) with a left ventricular ejection fraction of < 50%. As for patients who participated in the remote CR program, telephone support was provided by cardiologists and nurses who specialized in HF every 2 weeks after discharge. The emergency readmission rate within 30 days of discharge was compared among the outpatient CR, remote CR, and non-CR groups, and the EQ-5D score was compared between the outpatient CR and remote CR groups. RESULTS: The participation rate of HF patients in our remote CR program elevated during the COVID-19 pandemic. As observed in the outpatient CR group (n = 69), the emergency readmission rate within 30 days of discharge was lower in the remote CR group (n = 30) than in the non-CR group (n = 137) (P = 0.02). The EQ-5D score was higher in the remote CR group than in the outpatient CR group (P = 0.03) 30 days after discharge. CONCLUSIONS: Remote CR is as effective as outpatient CR for improving the short-term prognosis of patients hospitalized for heart failure post-discharge. This suggests that the remote CR program can be provided as a good alternative to the outpatient CR program.


Assuntos
Reabilitação Cardíaca/métodos , Infecções por Coronavirus/epidemiologia , Insuficiência Cardíaca/reabilitação , Pneumonia Viral/epidemiologia , Autocuidado , Telemedicina/métodos , Idoso , Betacoronavirus , Humanos , Japão , Pessoa de Meia-Idade , Monitorização Ambulatorial , Pandemias , Estudos Prospectivos , Telefone
15.
Acta Biomed ; 91(3): e2020022, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32921719

RESUMO

COVID-19 has had a catastrophic effect on healthcare systems compromising the treatment of cancer patients. It has an increased disease burden in the cancer population. As a result, tele-oncology services have become essential to reduce the risk of cancer patients being exposed to the deadly pathogen. Many governmental establishments have endorsed the use of tele-oncology during COVID-19 era. However, telemedicine in oncology still has certain drawbacks that can be improved upon. Nevertheless, tele-oncology has shown great promise to support cancer care not only during this pandemic but also become a part of normal care in the future.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Assistência à Saúde/métodos , Oncologia , Neoplasias/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Telemedicina/métodos , Terapia Combinada , Comorbidade/tendências , Humanos , Neoplasias/terapia
16.
Acta Biomed ; 91(3): e2020028, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32921723

RESUMO

This article reviews the current knowledges of congenital bleeding disorders (CBD) amid the COVID-19 pandemic. It appears that CBD is not associated with higher risk of getting COVID-19 and so the prevalence of COVID-19 among them seems not higher compared to the general population. In absence of specific therapeutic recommendations, it is essential to make a correct assessment of the risk of haemorrhage/thrombosis. Based on expert opinion, strategies for outpatient management include adherence to prescribed regimens, telemedicine, and communication about COVID-19 in patients with CBD. More data should be also collected to better characterize the impact of COVID-19 on patients with CBD. The current findings encourage further studies to determine the prevalence of SARS-CoV2 infection in CBD patients to understand more fully the burden of this novel pathogen and to develop adequate preventive measures against this infection.


Assuntos
Betacoronavirus , Transtornos Herdados da Coagulação Sanguínea/epidemiologia , Infecções por Coronavirus/epidemiologia , Gerenciamento Clínico , Guias como Assunto , Pandemias , Pneumonia Viral/epidemiologia , Telemedicina/métodos , Transtornos Herdados da Coagulação Sanguínea/terapia , Humanos , Pacientes Ambulatoriais
17.
Acta Biomed ; 91(3): e2020033, 2020 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-32921727

RESUMO

Due to the current COVID-19 pandemic, worldwide population's lifestyle has changed dramatically, causing psychosocial consequences.  Patients presenting a preexisting chronic condition, as Type 1 Diabetes (T1D), are the ones suffering the most from this situation. Moreover, people affected by diabetes are the ones with the worst prognosis, if infected by SARS-CoV-2.  We analyzed why patients with T1D were poorly represented between the subjects hospitalized for COVID-19 and why the cases of diabetic ketoacidosis (DKA) were fewer and more severe compared with the past years. Furthermore, literature has showed how patients of all ages with T1D did not experience a deterioration in their glucose control throughout the lockdown. Among other causes, this is also due to the surging use of telemedicine. Finally, we tried to understand how the coronavirus tropism for endocrine tissues could influence the future epidemiology of T1D, focusing on the effects they have on pancreatic ß-cells.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus Tipo 1/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Saúde Global , Humanos , Prevalência , Fatores de Risco , Telemedicina/métodos
18.
Medicina (Kaunas) ; 56(9)2020 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-32927589

RESUMO

Covid-19 is a new highly contagious RNA viral disease that has caused a global pandemic. Human-to-human transmission occurs primarily through oral and nasal droplets and possibly through the airborne route. The disease may be asymptomatic or the course may be mild with upper respiratory symptoms, moderate with non-life-threatening pneumonia, or severe with pneumonia and acute respiratory distress syndrome. The severe form is associated with significant morbidity and mortality. While patients who are unstable and in acute distress need immediate in-person attention, many patients can be evaluated at home by telemedicine or videoconferencing. The more benign manifestations of Covid-19 may be managed from home to maintain quarantine, thus avoiding spread to other patients and health care workers. This document provides an overview of the clinical presentation of Covid-19, emphasizing telemedicine strategies for assessment and triage of patients. Advantages of the virtual visit during this time of social distancing are highlighted.


Assuntos
Infecções por Coronavirus , Pandemias , Pneumonia Viral , Telemedicina/métodos , Triagem , Betacoronavirus/isolamento & purificação , Controle de Doenças Transmissíveis/métodos , Controle de Doenças Transmissíveis/organização & administração , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Transmissão de Doença Infecciosa/prevenção & controle , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/etiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Avaliação de Sintomas/métodos , Triagem/métodos , Triagem/organização & administração
20.
Indian J Ophthalmol ; 68(10): 2199-2201, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32971640

RESUMO

To describe a smartphone-based telemedicine tool for monitoring of corneal ulcer size during the corona pandemic, a simple "U"-shaped tool was constructed using three Schirmer's strips that were provided to the patients with small to medium-sized corneal ulcers. The patient and the attendant were trained to use this simple U-shaped tool at home and send digital images to the treating ophthalmologist, to monitor the course of the ulcer. The tool was used in five eyes of five patients with active microbial keratitis. Patients were followed up regularly with the use of telemedicine facility every 48 h for an average duration of 7.6 days (range 6-9 days). In all the five eyes, assessment of the serial images with U-shaped tool showed decrease in size of corneal ulcer, which corroborated with subjective improvement in symptoms. Hence, the novel "'U'-shaped tool" may provide an effective measure in following-up of corneal ulcer patients in times of the COVID-19 pandemic, obviating frequent hospital visits and risk of contracting COVID.


Assuntos
Betacoronavirus , Úlcera da Córnea/diagnóstico , Infecções por Coronavirus/epidemiologia , Técnicas de Diagnóstico Oftalmológico/instrumentação , Infecções Oculares Bacterianas/diagnóstico , Pneumonia Viral/epidemiologia , Smartphone/instrumentação , Telemedicina/métodos , Adulto , Idoso , Pré-Escolar , Úlcera da Córnea/microbiologia , Infecções Oculares Bacterianas/microbiologia , Feminino , Seguimentos , Humanos , Índia/epidemiologia , Masculino , Pandemias , Projetos Piloto , Microscopia com Lâmpada de Fenda
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