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1.
Artigo em Inglês | MEDLINE | ID: mdl-33167478

RESUMO

The outbreak of the COVID-19 pandemic has caused changes in the provision of psychotherapy around the world. The common format of delivering in-person psychotherapy is replaced by psychotherapy via the Internet to a great extent. This study examined how well Austrian psychotherapists feel informed about the use of the Internet in psychotherapy, where additional information needs exist, and which software is used. A link to an online survey was sent to all psychotherapists providing a valid email address in the official list of licensed psychotherapists at the start of the COVID-19 lockdown in Austria. A total of 1547 people took part in the survey. The results show that psychotherapy via the Internet was primarily offered via Skype and Zoom during the COVID-19 pandemic and that the majority of the therapists felt well-informed about psychotherapy via the Internet; however, several therapists stated that they wish to have further information on data protection and security. Overall, the study shows that Austrian psychotherapists coped well with the rapid change from the provision of psychotherapy through personal contact to psychotherapy via the Internet. Security and data protection aspects of therapy via the Internet should be addressed in training and further education of psychotherapists. As this study was conducted online, it might have caused some respondent bias towards a higher participation of psychotherapists with higher preference for new technologies.


Assuntos
Intervenção Baseada em Internet , Psicoterapia/educação , Psicoterapia/tendências , Telemedicina/tendências , Áustria , Betacoronavirus , Infecções por Coronavirus , Educação Continuada , Humanos , Pandemias , Pneumonia Viral
2.
Biomed Instrum Technol ; 54(4): 242-250, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-33171500

RESUMO

Could COVID-19 provide the push telehealth needs to finally gain widespread acceptance? Although many in healthcare saw it coming, no one predicted it would happen this fast. Telehealth services, in step with the coronavirus, started out at a slow crawl in early March. Soon, telehealth would begin hitting its stride-and would reach a full sprint no more than a month or two later.


Assuntos
Infecções por Coronavirus , Pandemias , Pneumonia Viral , Telemedicina/tendências , Betacoronavirus , Humanos
3.
Rev Assoc Med Bras (1992) ; 66(10): 1320-1322, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33174918

RESUMO

The coronavirus pandemic (COVID-19) brought up discussions about improvements in both primary healthcare and hospital care in Brasil. In addition, the use of information and communication technology tools has become more prominent in the transmission of health information to patients remotely. Through content dissemination actions for professionals and direct guidance to users, remote telehealth/telemedicine services offer qualified actions that can reduce unnecessary referrals and decrease the flow of patients in health units. Information and communication technologies are allies in the fight against COVID-19.


Assuntos
Infecções por Coronavirus/epidemiologia , Disseminação de Informação/métodos , Pneumonia Viral/epidemiologia , Telemedicina/tendências , Betacoronavirus , Brasil , Humanos , Pandemias
4.
Biomedica ; 40(Supl. 2): 77-79, 2020 10 30.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-33152191

RESUMO

The COVID-19 pandemic has generated a revolution of such magnitude that no aspect of human life will be the same from now on. The provision of health services and health education are not unrelated to this new normality imposed by the disease, and its consequences have been reflected in the need to use protocols and resources based on virtuality that most of us had not valued in their real dimension. Telehealth and telemedicine will be basic tools for professionals and teachers and it is our obligation to know them, apply them, and innovate to adapt to this reality.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Telemedicina/tendências , Colômbia/epidemiologia , Confidencialidade , Infecções por Coronavirus/prevenção & controle , Educação a Distância , Programas Governamentais , Instalações de Saúde , Acesso aos Serviços de Saúde , Humanos , Disseminação de Informação , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Utilização de Procedimentos e Técnicas , Telemedicina/métodos , Telemedicina/organização & administração , Telemedicina/estatística & dados numéricos , Universidades , Recursos Humanos
5.
Neurosurg Focus ; 49(5): E8, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33130613

RESUMO

The Emergency Medical Treatment and Active Labor Act (EMTALA) protects patient access to emergency medical treatment regardless of insurance or socioeconomic status. A significant result of the COVID-19 pandemic has been the rapid acceleration in the adoption of telemedicine services across many facets of healthcare. However, very little literature exists regarding the use of telemedicine in the context of EMTALA. This work aimed to evaluate the potential to expand the usage of telemedicine services for neurotrauma to reduce transfer rates, minimize movement of patients across borders, and alleviate the burden on tertiary care hospitals involved in the care of patients with COVID-19 during a global pandemic. In this paper, the authors outline EMTALA provisions, provide examples of EMTALA violations involving neurosurgical care, and propose guidelines for the creation of telemedicine protocols between referring and consulting institutions.


Assuntos
Betacoronavirus , Concussão Encefálica/terapia , Centers for Medicare and Medicaid Services, U.S./legislação & jurisprudência , Infecções por Coronavirus/terapia , Serviços Médicos de Emergência/legislação & jurisprudência , Pneumonia Viral/terapia , Telemedicina/legislação & jurisprudência , Concussão Encefálica/epidemiologia , Centers for Medicare and Medicaid Services, U.S./tendências , Infecções por Coronavirus/epidemiologia , Serviços Médicos de Emergência/tendências , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Telemedicina/tendências , Centros de Atenção Terciária/legislação & jurisprudência , Centros de Atenção Terciária/tendências , Estados Unidos/epidemiologia
7.
MMWR Morb Mortal Wkly Rep ; 69(43): 1595-1599, 2020 10 30.
Artigo em Inglês | MEDLINE | ID: mdl-33119561

RESUMO

In February 2020, CDC issued guidance advising persons and health care providers in areas affected by the coronavirus disease 2019 (COVID-19) pandemic to adopt social distancing practices, specifically recommending that health care facilities and providers offer clinical services through virtual means such as telehealth.* Telehealth is the use of two-way telecommunications technologies to provide clinical health care through a variety of remote methods.† To examine changes in the frequency of use of telehealth services during the early pandemic period, CDC analyzed deidentified encounter (i.e., visit) data from four of the largest U.S. telehealth providers that offer services in all states.§ Trends in telehealth encounters during January-March 2020 (surveillance weeks 1-13) were compared with encounters occurring during the same weeks in 2019. During the first quarter of 2020, the number of telehealth visits increased by 50%, compared with the same period in 2019, with a 154% increase in visits noted in surveillance week 13 in 2020, compared with the same period in 2019. During January-March 2020, most encounters were from patients seeking care for conditions other than COVID-19. However, the proportion of COVID-19-related encounters significantly increased (from 5.5% to 16.2%; p<0.05) during the last 3 weeks of March 2020 (surveillance weeks 11-13). This marked shift in practice patterns has implications for immediate response efforts and longer-term population health. Continuing telehealth policy changes and regulatory waivers might provide increased access to acute, chronic, primary, and specialty care during and after the pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Telemedicina/estatística & dados numéricos , Telemedicina/tendências , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Estados Unidos/epidemiologia , Adulto Jovem
9.
J Diabetes Sci Technol ; 14(6): 1107-1110, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33050727

RESUMO

With the recent pivot to telehealth as a direct result of the COVID-19 pandemic, there is an imperative to ensure that access to affordable devices and technologies with remote monitoring capabilities for people with diabetes becomes equitable. In addition, expanding the use of remote Diabetes Self-Management Education and Support (DSMES) and Medical Nutrition Therapy (MNT) services will require new strategies for achieving long-term, effective, continuous, data-driven care. The current COVID-19 pandemic has especially impacted underserved US communities that were already disproportionately impacted by diabetes. Historically, these same communities have faced barriers in accessing timely and effective diabetes care including access to DSMES and MNT services, and diabetes technologies. Our call to action encourages all involved to urge US Federal representatives to widen access to the array of technologies necessary for successful telehealth-delivered care beyond COVID-19.


Assuntos
Computação em Nuvem/tendências , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus/terapia , Acesso aos Serviços de Saúde/tendências , Pneumonia Viral/epidemiologia , Telemedicina/tendências , Assistência de Saúde Universal , Infecções por Coronavirus/terapia , Democracia , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/terapia , Diabetes Mellitus/epidemiologia , Acesso aos Serviços de Saúde/organização & administração , Disparidades em Assistência à Saúde/organização & administração , Disparidades em Assistência à Saúde/tendências , Humanos , Invenções/tendências , Área Carente de Assistência Médica , Pandemias , Educação de Pacientes como Assunto/métodos , Educação de Pacientes como Assunto/organização & administração , Educação de Pacientes como Assunto/tendências , Pneumonia Viral/terapia , Autogestão/métodos , Autogestão/tendências , Telemedicina/métodos , Telemedicina/organização & administração
10.
Artigo em Inglês | MEDLINE | ID: mdl-33096650

RESUMO

The use of digital information and communication technologies (ICTs) has enabled many professionals to continue to provide their services during the COVID-19 pandemic. However, little is known about the adoption of ICTs by psychologists and the impact of such technologies on their practice. This study aimed to explore psychologists' practices related with the use of ICTs before and during the COVID-19 lockdown, to identify the main changes that the pandemic has brought and the impact that such changes have had on their practice with clients, and also identify the factors that potentially have affected such changes. The Portuguese Psychologists Association announced the study, and 108 psychologists responded to an online survey during the mandatory lockdown. The results showed that these professionals continued to provide their services due to having adopted ICTs. Comparing with face-to-face interventions, psychologists recognized that additional precautions/knowledge were needed to use such technologies. Despite the challenges identified, they described the experience with the use of ICTs as positive, meeting clients' adherence, and yielding positive results. Psychologists with the most years of professional experience maintained their services the most, but those with average experience showed the most favorable attitudes toward the use of technologies and web-based interventions.


Assuntos
Infecções por Coronavirus/psicologia , Aconselhamento/tendências , Intervenção Baseada em Internet/tendências , Pneumonia Viral/psicologia , Psicoterapia/tendências , Telemedicina/tendências , Betacoronavirus , Humanos , Pandemias
11.
Praxis (Bern 1994) ; 109(14): 1135-1140, 2020.
Artigo em Alemão | MEDLINE | ID: mdl-33108998

RESUMO

Telemedicine in Rhythmology - Prepared for Pandemics Abstract. The COVID-19 pandemic urged us to reorganize many of our daily clinical processes. In this regard, the protection of vulnerable patient populations is of particular importance, since any visit to the outpatient clinic implies the risk of exposure to and infection with the SARS-CoV-2 virus. Nevertheless, patients with a pacemaker, an implantable cardioverter/defibrillator (ICD) or an implantable cardiac monitor need regular follow-up to assure proper functionality of these devices. Remote monitoring is the ideal solution to meet the requirements of patient protection and device safety during pandemics. Besides, remote monitoring has already proved its value in normal times. This article summarizes the functionality of remote monitoring, describes the patient benefit and associated challenges and opportunities.


Assuntos
Infecções por Coronavirus , Desfibriladores Implantáveis , Monitorização Fisiológica/métodos , Marca-Passo Artificial , Pandemias , Pneumonia Viral , Telemedicina/tendências , Betacoronavirus , Humanos
12.
Z Rheumatol ; 79(9): 883-892, 2020 Nov.
Artigo em Alemão | MEDLINE | ID: mdl-33057786

RESUMO

Due to the outbreak of the COVID-19 pandemic, in recent months we have experienced deep changes in our daily and professional lives. In the context of pandemic containment, routine rheumatological procedures have changed in many areas. To guarantee sufficient protection against the infection for patients and staff, telemedicine (especially telephone and video consultation) has increasingly been used. Due to the Digital Healthcare Act (DiGAV), whereby patients will have a legal claim to specific digital health applications in Germany, medical apps and wearables will offer new opportunities for telemedical monitoring. This article provides an overview of telemedical care options in the field of rheumatology. Furthermore, opportunities and limitations of telemedicine in rheumatology are reviewed.


Assuntos
Infecções por Coronavirus/epidemiologia , Pneumonia Viral/epidemiologia , Reumatologia/tendências , Telemedicina/tendências , Betacoronavirus , Alemanha , Humanos , Aplicativos Móveis , Pandemias , Dispositivos Eletrônicos Vestíveis
13.
J Crohns Colitis ; 14(Supplement_3): S780-S784, 2020 Oct 21.
Artigo em Inglês | MEDLINE | ID: mdl-33085971

RESUMO

Before the onset of the COVID-19 pandemic, the majority of care for inflammatory bowel disease patients was provided in-person. The practice of gastroenterology care has since rapidly transformed, with telemedicine emerging as an essential tool to provide medical care to patients while maintaining social distancing and conserving personal protective equipment. This article provides insight into past and current practices among inflammatory bowel disease specialists and shares regulatory, financial and practical considerations for incorporating telemedicine into clinical practice. Continued government and other payer support for telemedicine and ongoing innovation to provide remote objective patient data will help to sustain the use of telemedicine long after the current pandemic subsides.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Gastroenterologia/métodos , Doenças Inflamatórias Intestinais/terapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Padrões de Prática Médica/tendências , Telemedicina/métodos , Gastroenterologia/organização & administração , Gastroenterologia/tendências , Saúde Global , Humanos , Doenças Inflamatórias Intestinais/complicações , Padrões de Prática Médica/normas , Telemedicina/organização & administração , Telemedicina/tendências
16.
Isr J Health Policy Res ; 9(1): 53, 2020 10 20.
Artigo em Inglês | MEDLINE | ID: mdl-33081834

RESUMO

BACKGROUND: Facing the global health crisis of COVID-19, health systems are increasingly supporting the use of telemedicine in ambulatory care settings. It is not clear whether the increased use of telemedicine will persist after the pandemic has resolved. The aims of this study were to assess the use of telemedicine by Israeli pediatricians before and during the first lockdown phase of the pandemic, and to elucidate how they foresee telemedicine as a medium of medical practice in the post-pandemic era. METHODS: A web-based survey was distributed among Israeli pediatricians in May 2020, soon after the end of first lockdown was announced. The survey assessed the frequency of telemedicine use as well as its influence on clinical decision making before and during the first COVID-19 lockdown, using two hypothetical clinical scenarios. The same scenarios were also used to assess how the pediatricians foresaw telemedicine in the post-pandemic period. In addition, administrative data from Maccabi on telemedicine use before, during and after the first lockdown were retrieved and analyzed. RESULTS: One hundred and sixty-nine pediatricians responded to the survey (response rate = 40%). The percentage of respondents who reported daily use of text messages, pictures and videoconferencing increased from 24, 15 and 1% before COVID-19 to 40, 40 and 12% during the lockdown, respectively (p < 0.05). After the pandemic, projected use of text messages and pictures/videoclips was expected to decrease to 27 and 26% of respondents, respectively (p < 0.05), but pictures/videoclips were expected to increase from 15% of respondents before to 26% of respondents after (p < 0.05). The reported high likelihood of treating suspected pneumonia or prescribing antibiotics for suspected otitis media via telemedicine was expected to decrease from 20% of respondents during the COVID-19 lockdown to 6%% of respondents after (p < 0.05), and from 14% of respondents during the lockdown to 3% of respondents after, respectively. (p < 0.05). Maccabi administrative data indicated that during the lockdown, there was an increase in phone visits and a decrease in in-person visits compared to the pre-lockdown levels of use. One month after the end of the first lock-down there was a partial return to baseline levels of in-person visits and a sustained increase in phone visits. Phone visits accounted for 0% of pediatrician visits before the first lockdown, 17% of them during the lockdown, and 19% of them 1 month after the lockdown relaxation. CONCLUSIONS: The study indicates that use of telemedicine technologies by primary care pediatricians increased substantially during the first COVID-19 lockdown. The study also found that pediatricians expected that use levels will recede after the pandemic. As the pandemic continues and evolves, it will be important to continue to monitor the level of telemedicine use as well as expectations regarding post-pandemic use levels.


Assuntos
Atitude do Pessoal de Saúde , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pediatras/psicologia , Pneumonia Viral/prevenção & controle , Atenção Primária à Saúde/organização & administração , Telemedicina/tendências , Adulto , Idoso , Criança , Infecções por Coronavirus/epidemiologia , Feminino , Previsões , Humanos , Israel/epidemiologia , Masculino , Pessoa de Meia-Idade , Pediatras/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Política Pública , Quarentena
17.
J Stroke Cerebrovasc Dis ; 29(11): 105228, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33066882

RESUMO

BACKGROUND: This report aims to describe changes that centres providing transient ischaemic attack (TIA) pathway services have made to stay operational in response to the SARS-CoV-2 pandemic. METHODS: An international cross-sectional description of the adaptions of TIA pathways between 30th March and 6th May 2020. Experience was reported from 18 centres with rapid TIA pathways in seven countries (Australia, France, UK, Canada, USA, New Zealand, Italy, Canada) from three continents. RESULTS: All pathways remained active (n = 18). Sixteen (89%) had TIA clinics. Six of these clinics (38%) continued to provide in-person assessment while the majority (63%) used telehealth exclusively. Of these, three reported PPE use and three did not. Five centres with clinics (31%) had adopted a different vascular imaging strategy. CONCLUSION: The COVID pandemic has led TIA clinics around the world to adapt and move to the use of telemedicine for outpatient clinic review and modified investigation pathways. Despite the pandemic, all have remained operational.


Assuntos
Infecções por Coronavirus/terapia , Procedimentos Clínicos/tendências , Prestação Integrada de Cuidados de Saúde/tendências , Equipe de Respostas Rápidas de Hospitais/tendências , Ataque Isquêmico Transitório/terapia , Pneumonia Viral/terapia , Padrões de Prática Médica/tendências , Telemedicina/tendências , Austrália , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/virologia , Estudos Transversais , Diagnóstico por Imagem/tendências , Europa (Continente) , Humanos , Ataque Isquêmico Transitório/diagnóstico , Nova Zelândia , América do Norte , Pandemias , Equipamento de Proteção Individual/tendências , Pneumonia Viral/diagnóstico , Pneumonia Viral/virologia , Fatores de Tempo
18.
J Diabetes Res ; 2020: 9036847, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33123599

RESUMO

Recently, telemedicine has become remarkably important, due to increased deployment and development of digital technologies. National and international guidelines should consider its inclusion in their updates. During the COVID-19 pandemic, mandatory social distancing and the lack of effective treatments has made telemedicine the safest interactive system between patients, both infected and uninfected, and clinicians. A few potential evidence-based scenarios for the application of telemedicine have been hypothesized. In particular, its use in diabetes and complication monitoring has been remarkably increasing, due to the high risk of poor prognosis. New evidence and technological improvements in telemedicine application in diabetic retinopathy (DR) have demonstrated efficacy and usefulness in screening. Moreover, despite an initial increase for devices and training costs, teleophthalmology demonstrated a good cost-to-efficacy ratio; however, no national screening program has yet focused on DR prevention and diagnosis. Lack of data during the COVID-19 pandemic strongly limits the possibility of tracing the real management of the disease, which is only conceivable from past evidence in normal conditions. The pandemic further stressed the importance of remote monitoring. However, the deployment of device and digital application used to increase screening of individuals and monitor progression of retinal disease needs to be easily accessible to general practitioners.


Assuntos
Infecções por Coronavirus/epidemiologia , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/terapia , Pandemias , Pneumonia Viral/epidemiologia , Telemedicina , Betacoronavirus/fisiologia , Análise Custo-Benefício , Retinopatia Diabética/epidemiologia , Humanos , Programas de Rastreamento/economia , Programas de Rastreamento/métodos , Programas de Rastreamento/organização & administração , Programas de Rastreamento/tendências , Oftalmologia/economia , Oftalmologia/métodos , Oftalmologia/organização & administração , Oftalmologia/tendências , Telemedicina/economia , Telemedicina/organização & administração , Telemedicina/normas , Telemedicina/tendências
19.
World J Gastroenterol ; 26(36): 5387-5394, 2020 Sep 28.
Artigo em Inglês | MEDLINE | ID: mdl-33024391

RESUMO

The current coronavirus pandemic is imposing unpreceded challenges to the practice of pediatric gastroenterology. These are highlighted in their impact on performing aerosol-generating endoscopy procedures and the need to accommodate longer room turnaround time for disinfection, ensuring appropriate and consistent safety measures for patients, staff and providers, and emphasizing the importance for screening patients for active coronavirus disease (COVID) infection before endoscopy when possible. Pediatric patients are less likely to exhibit severe COVID-related symptoms so survey-based screening would not be a sensitive measure to identify patients with active infections. To address the restrictions of patients coming for face to face clinic encounters, there has been rapid expansion of telehealth services in a very short time period with several difficulties encountered. To survive these challenges, pediatric gastroenterology practices need to adapt and accept flexibility in clinical operations with ongoing commitment to safety for patients and healthcare workers.


Assuntos
Infecções por Coronavirus , Gastroenterologia/métodos , Controle de Infecções/métodos , Pandemias , Segurança do Paciente , Pediatria/métodos , Pneumonia Viral , Betacoronavirus , Humanos , Telemedicina/tendências
20.
J Med Internet Res ; 22(10): e22146, 2020 10 06.
Artigo em Inglês | MEDLINE | ID: mdl-32903195

RESUMO

BACKGROUND: As the COVID-19 pandemic disrupted medical practice, telemedicine emerged as an alternative to outpatient visits. However, it is not known how patients and physicians responded to an accelerated implementation of this model of medical care. OBJECTIVE: The aim of this study is to report the system-wide accelerated implementation of telemedicine, compare patient satisfaction between telemedicine and in-person visits, and report provider perceptions. METHODS: This study was conducted at the UC Christus Health Network, a large private academic health network in Santiago, Chile. The satisfaction of patients receiving telemedicine care in March and April 2020 was compared to those receiving in-person care during the same period (concurrent control group) as well as in March and April 2019 (retrospective control group). Patient satisfaction with in-person care was measured using the Net Promoter Score (NPS) survey. Patient satisfaction with telemedicine was assessed with an online survey assessing similar domains. Providers rated their satisfaction and responded to open-ended questions assessing challenges, strategies used to address challenges, the diagnostic process, treatment, and the patient-provider relationship. RESULTS: A total of 3962 patients receiving telemedicine, 1187 patients from the concurrent control group, and 1848 patients from the retrospective control group completed the surveys. Satisfaction was very high with both telemedicine and in-person services. Overall, 263 physicians from over 41 specialties responded to the survey. During telemedicine visits, most providers felt their clinical skills were challenged (61.8%). Female providers felt more challenged than male providers (70.7% versus 50.9%, P=.002). Surgeons, obstetricians, and gynecologists felt their clinical skills were challenged the least, compared to providers from nonsurgical specialties (P<.001). Challenges related to the delivery modality, diagnostic process, and patient-provider relationship differed by provider specialty (P=.046, P<.001, and P=.02, respectively). CONCLUSIONS: Telemedicine implemented in response to the COVID-19 pandemic produced high patient and provider satisfaction. Specialty groups perceived the impact of this new mode of clinical practice differently.


Assuntos
Infecções por Coronavirus/epidemiologia , Satisfação do Paciente , Pneumonia Viral/epidemiologia , Telemedicina/métodos , Centros Médicos Acadêmicos , Adolescente , Adulto , Idoso , Betacoronavirus , Criança , Pré-Escolar , Chile/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Satisfação no Emprego , Masculino , Pessoa de Meia-Idade , Pandemias , Pesquisa Qualitativa , Projetos de Pesquisa , Estudos Retrospectivos , Inquéritos e Questionários , Telemedicina/tendências , Adulto Jovem
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