Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 1.081
Filtrar
1.
Recurso educacional aberto em Português | CVSP - Regional | ID: oer-3910

RESUMO

Fast- Track em saúde bucal Atendimento de urgência em odontologia Equipamentos de proteção Individual


Assuntos
Pandemias/prevenção & controle , Protocolos Clínicos , Saúde Bucal , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle
2.
G Ital Nefrol ; 37(5)2020 Oct 05.
Artigo em Italiano | MEDLINE | ID: mdl-33026199

RESUMO

Lombardy was violently hit by Covid-19 between the end of February and the beginning of March 2020. On 09.05.2020 there were 81225 total registered Covid-19+ cases (8051 / million inhabitants) with 14924 deaths (1479 deaths / million inhabitants). The province of Cremona presented a higher number of Covid-19+ cases and a worse relative mortality than the already high regional average. Patients on regular hemodialysis treatment present a high risk of infection due to the co-pathologies present, while healthcare workers may represent a risk for themselves and for the patients, due to the treatment environment and the close contact with them. All patients and healthcare workers of the Dialysis Center in Crema were evaluated (oro-pharyngeal swab for viral RNA research, qualitative anti-Covid-19 antibodies, quantitative IgG antibodies, co-pathologies), regardless of the symptomatology, over a 60-day period. Hemodialysis patients have a risk of infection that is 12.7 times that of the local population, while healthcare workers outperform the patients for Covid-positivity (30.3% vs 21.6%). Lethality in infected patients is high (31% of Covid-19+ subjects), while it is zero among healthcare professionals. The antibody response (qualitative and quantitative) in Covid-19+ patients is adequate, when compared to that of Covid-19+ healthcare staff. In our Center, the most critical phase lasted about 45 days but, thanks to the measures taken, it was possible to make the dialysis area Covid-free, as it remains after 128 days.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Falência Renal Crônica/epidemiologia , Pandemias , Pneumonia Viral/epidemiologia , Diálise Renal , Adulto , Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Emergências , Feminino , Pessoal de Saúde , Unidades Hospitalares de Hemodiálise/estatística & dados numéricos , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Itália/epidemiologia , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Orofaringe/virologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Risco , Taxa de Sobrevida
3.
G Ital Nefrol ; 37(5)2020 Oct 05.
Artigo em Italiano | MEDLINE | ID: mdl-33026201

RESUMO

Coronavirus disease 2019 is an infectious respiratory syndrome caused by the virus called SARS-CoV-2, belonging to the family of coronaviruses. The first ever cases were detected during the 2019-2020 pandemic. Coronaviruses can cause a common cold or more serious diseases such as Middle Eastern Respiratory Syndromes (MERS) and Severe Acute Respiratory Syndrome (SARS). They can cause respiratory, lung and gastrointestinal infections with a mild to severe course, sometimes causing the death of the infected person. This new strain has no previous identifiers and its epidemic potential is strongly associated with the absence of immune response/reactivity and immunological memory in the world population, which has never been in contact with this strain before. Most at risk are the elderly, people with pre-existing diseases and/or immunodepressed, dialyzed and transplanted patients, pregnant women, people with debilitating chronic diseases. They are advised to avoid contacts with other people, unless strictly necessary, and to stay away from crowded places, also observing scrupulously the recommendations of the Istituto Superiore di Sanità. In this article we detail the recommendations that must be followed by the nursing care staff when dealing with chronic kidney disease patients in dialysis or with kidney transplant patients. We delve into the procedures that are absolutely essential in this context: social distancing of at least one meter, use of PPI, proper dressing and undressing procedures, frequent hand washing and use of gloves, and finally the increase of dedicated and appropriately trained health personnel on ward.


Assuntos
Betacoronavirus , Infecções por Coronavirus/enfermagem , Infecção Hospitalar/prevenção & controle , Controle de Infecções/métodos , Transplante de Rim/enfermagem , Pandemias , Pneumonia Viral/enfermagem , Guias de Prática Clínica como Assunto , Diálise Renal/enfermagem , Insuficiência Renal Crônica/enfermagem , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Desinfecção , Desinfecção das Mãos , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Resíduos de Serviços de Saúde , Processo de Enfermagem/normas , Registros de Enfermagem , Pandemias/prevenção & controle , Isolamento de Pacientes , Equipamento de Proteção Individual , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Insuficiência Renal Crônica/cirurgia , Insuficiência Renal Crônica/terapia , Precauções Universais
4.
JCO Glob Oncol ; 6: 1494-1509, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-33017179

RESUMO

PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has had a global impact, and Singapore has seen 33,000 confirmed cases. Patients with cancer, their caregivers, and health care workers (HCWs) need to balance the challenges associated with COVID-19 while ensuring that cancer care is not compromised. This study aimed to evaluate the psychological effect of COVID-19 on these groups and the prevalence of burnout among HCWs. METHODS: A cross-sectional survey of patients, caregivers, and HCWs at the National Cancer Centre Singapore was performed over 17 days during the lockdown. The Generalized Anxiety Disorder-7 and Maslach Burnout Inventory were used to assess for anxiety and burnout, respectively. Self-reported fears related to COVID-19 were collected. RESULTS: A total of 624 patients, 408 caregivers, and 421 HCWs participated in the study, with a response rate of 84%, 88%, and 92% respectively. Sixty-six percent of patients, 72.8% of caregivers, and 41.6% of HCWs reported a high level of fear from COVID-19. The top concern of patients was the wide community spread of COVID-19. Caregivers were primarily worried about patients dying alone. HCWs were most worried about the relatively mild symptoms of COVID-19. The prevalence of anxiety was 19.1%, 22.5%, and 14.0% for patients, caregivers, and HCWs, respectively. Patients who were nongraduates and married, and caregivers who were married were more anxious. The prevalence of burnout in HCWs was 43.5%, with more anxious and fearful HCWs reporting higher burnout rates. CONCLUSION: Fears and anxiety related to COVID-19 are high. Burnout among HCWs is similar to rates reported prepandemic. An individualized approach to target the specific fears of each group will be crucial to maintain the well-being of these vulnerable groups and prevent burnout of HCWs.


Assuntos
Ansiedade/epidemiologia , Esgotamento Profissional/epidemiologia , Cuidadores/psicologia , Infecções por Coronavirus/psicologia , Neoplasias/psicologia , Pneumonia Viral/psicologia , Adulto , Idoso , Ansiedade/diagnóstico , Ansiedade/psicologia , Betacoronavirus/patogenicidade , Esgotamento Profissional/diagnóstico , Esgotamento Profissional/psicologia , Institutos de Câncer/organização & administração , Institutos de Câncer/normas , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Estudos Transversais , Medo/psicologia , Feminino , Pessoal de Saúde/psicologia , Acesso aos Serviços de Saúde/organização & administração , Acesso aos Serviços de Saúde/normas , Humanos , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Masculino , Oncologia/organização & administração , Oncologia/normas , Pessoa de Meia-Idade , Neoplasias/terapia , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Prevalência , Singapura/epidemiologia , Carga de Trabalho/psicologia
5.
Rev Neurol ; 71(9): 340-350, 2020 11 01.
Artigo em Espanhol | MEDLINE | ID: mdl-33085079

RESUMO

At the end of January, the current outbreak of COVID-19 coronavirus disease was declared an important international public health emergency. In Spain, since the government declared the state of alarm on 14 March 2020, doctors responsible for carrying out neurophysiological tests have been performing them without any consensus criterion or clear safety guidelines for doctors, technicians or patients. The following recommendations, based on current knowledge of the disease and therefore liable to change in the future, are proposed when the pandemic appears to have entered a process of decreasing virulence and, with it, the strict containment measures established to date. However, in view of the possibility of a second wave of the pandemic, it seems necessary to establish basic and minimum recommendations to respect the patient's right to appropriate care, similar to that provided prior to the pandemic, and to maintain minimum safety standards for the patients themselves and for the doctors, technicians and health personnel carrying out these tests. These recommendations concern the constitution of a priority based on the reason for consultation, the establishment of calls to check the patient's clinical situation before going to the outpatient department and the rules for carrying out neurophysiological tests, which are generally based on the preservation of hospital circuits, respect for and observation of the known barriers to contagion of this disease, and the use of disposable material. These recommendations are of particular interest, especially given the uncertainty of not knowing the evolution of the SARS-CoV-2 infection in the coming weeks or months.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Eletrofisiologia , Controle de Infecções/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Guias de Prática Clínica como Assunto , Assistência Ambulatorial , Continuidade da Assistência ao Paciente , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecção Hospitalar/prevenção & controle , Desinfecção , Eletrofisiologia/instrumentação , Eletrofisiologia/métodos , Eletrofisiologia/normas , Contaminação de Equipamentos , Humanos , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Pacientes Internados , Monitorização Intraoperatória , Exposição Ocupacional , Equipamento de Proteção Individual , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Utilização de Procedimentos e Técnicas , Espanha/epidemiologia , Avaliação de Sintomas , Telemedicina
6.
Anesth Analg ; 131(5): 1342-1354, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33079853

RESUMO

Many health care systems around the world continue to struggle with large numbers of SARS-CoV-2-infected patients, while others have diminishing numbers of cases following an initial surge. There will most likely be significant oscillations in numbers of cases for the foreseeable future, based on the regional epidemiology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Less affected hospitals and facilities will attempt to progressively resume elective procedures and surgery. Ramping up elective care in hospitals that deliberately curtailed elective care to focus on SARS-CoV-2-infected patients will present unique and serious challenges. Among the challenges will be protecting patients and providers from recurrent outbreaks of disease while increasing procedure throughput. Anesthesia providers will inevitably be exposed to SARS-CoV-2 by patients who have not been diagnosed with infection. This is particularly concerning in consideration that aerosols produced during airway management may be infective. In this article, we recommend an approach to routine anesthesia care in the setting of persistent but variable prevalence of SARS-CoV-2 infection. We make specific recommendations for personal protective equipment and for the conduct of anesthesia procedures and workflow based on evidence and expert opinion. We propose practical, relatively inexpensive precautions that can be applied to all patients undergoing anesthesia. Because the SARS-CoV-2 virus is spread primarily by respiratory droplets and aerosols, effective masking of anesthesia providers is of paramount importance. Hospitals should follow the recommendations of the Centers for Disease Control and Prevention for universal masking of all providers and patients within their facilities. Anesthesia providers should perform anesthetic care in respirator masks (such as N-95 and FFP-2) whenever possible, even when the SARS-CoV-2 test status of patients is negative. Attempting to screen patients for infection with SARS-CoV-2, while valuable, is not a substitute for respiratory protection of providers, as false-negative tests are possible and infected persons can be asymptomatic or presymptomatic. Provision of adequate supplies of respirator masks and other respiratory protection equipment such as powered air purifying respirators (PAPRs) should be a high priority for health care facilities and for government agencies. Eye protection is also necessary because of the possibility of infection from virus coming into contact with the conjunctiva. Because SARS-CoV-2 persists on surfaces and may cause infection by contact with fomites, hand hygiene and surface cleaning are also of paramount importance.


Assuntos
Anestesia , Betacoronavirus/patogenicidade , Infecções por Coronavirus/prevenção & controle , Infecção Hospitalar/prevenção & controle , Controle de Infecções , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Exposição por Inalação/prevenção & controle , Intubação Intratraqueal , Exposição Ocupacional/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Aerossóis , Anestesia/efeitos adversos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Infecção Hospitalar/diagnóstico , Infecção Hospitalar/transmissão , Infecção Hospitalar/virologia , Contaminação de Equipamentos/prevenção & controle , Dispositivos de Proteção dos Olhos , Higiene das Mãos , Interações Hospedeiro-Patógeno , Humanos , Exposição por Inalação/efeitos adversos , Intubação Intratraqueal/efeitos adversos , Exposição Ocupacional/efeitos adversos , Saúde do Trabalhador , Segurança do Paciente , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Fatores de Proteção , Dispositivos de Proteção Respiratória , Medição de Risco , Fatores de Risco , Vestimenta Cirúrgica
7.
Br J Nurs ; 29(17): 1003-1006, 2020 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-32972218

RESUMO

The significance of hand hygiene for preventing the transmission of microorganisms and reducing the spread of infection has been brought into sharp focus following the global coronavirus (COVID-19) pandemic. In the months since the initial outbreak, international public health campaigns and practitioner education has concentrated on hand washing and hand sanitising, with very little reference to hand drying, if any at all. However, hand drying is integral to effective hand hygiene, and is important in controlling the spread of microorganisms and maintaining healthy skin integrity. This research commentary will focus on two issues of importance with regards to hand drying: microbial transmission and skin irritation, with implications for healthcare practitioners and practice considered. It is argued that a more holistic approach to hand hygiene must be the ambition if health professional and public behaviour is to become embedded and sustained.


Assuntos
Infecções por Coronavirus/prevenção & controle , Higiene das Mãos/métodos , Higiene das Mãos/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecção Hospitalar/prevenção & controle , Mãos/virologia , Comportamentos Relacionados com a Saúde , Pessoal de Saúde/psicologia , Humanos , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Fenômenos Fisiológicos da Pele
8.
Rev Assoc Med Bras (1992) ; 66Suppl 2(Suppl 2): 102-105, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965366

RESUMO

INTRODUCTION: What has been published so far regarding safe methods to deal with chest tube insertion during COVID-19. METHODS: A descriptive study of the literature available in the Medline/PubMed, Lilacs, Scopus databases and specialized books. The search was carried out using the terms "infectious diseases"; "COVID-19"; "Chest tubes". RESULTS: This paper aggregates and consolidates some old concepts to new tactics to minimize the contamination of teams who deal with chest tubes, before, during, and after the procedure. CONCLUSIONS: Health officials are under increasing pressure to control the spread of COVID-19, which is a very virulent disease. Our analysis brought together old rules against contamination along with new tactics for professionals who deal with chest drains in order to minimize the contamination of teams during the Pandemic.


Assuntos
Tubos Torácicos/efeitos adversos , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias , Pneumonia Viral/epidemiologia
9.
MMWR Morb Mortal Wkly Rep ; 69(35): 1221-1226, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32881855

RESUMO

Health care personnel (HCP) caring for patients with coronavirus disease 2019 (COVID-19) might be at high risk for contracting SARS-CoV-2, the virus that causes COVID-19. Understanding the prevalence of and factors associated with SARS-CoV-2 infection among frontline HCP who care for COVID-19 patients are important for protecting both HCP and their patients. During April 3-June 19, 2020, serum specimens were collected from a convenience sample of frontline HCP who worked with COVID-19 patients at 13 geographically diverse academic medical centers in the United States, and specimens were tested for antibodies to SARS-CoV-2. Participants were asked about potential symptoms of COVID-19 experienced since February 1, 2020, previous testing for acute SARS-CoV-2 infection, and their use of personal protective equipment (PPE) in the past week. Among 3,248 participants, 194 (6.0%) had positive test results for SARS-CoV-2 antibodies. Seroprevalence by hospital ranged from 0.8% to 31.2% (median = 3.6%). Among the 194 seropositive participants, 56 (29%) reported no symptoms since February 1, 2020, 86 (44%) did not believe that they previously had COVID-19, and 133 (69%) did not report a previous COVID-19 diagnosis. Seroprevalence was lower among personnel who reported always wearing a face covering (defined in this study as a surgical mask, N95 respirator, or powered air purifying respirator [PAPR]) while caring for patients (5.6%), compared with that among those who did not (9.0%) (p = 0.012). Consistent with persons in the general population with SARS-CoV-2 infection, many frontline HCP with SARS-CoV-2 infection might be asymptomatic or minimally symptomatic during infection, and infection might be unrecognized. Enhanced screening, including frequent testing of frontline HCP, and universal use of face coverings in hospitals are two strategies that could reduce SARS-CoV-2 transmission.


Assuntos
Anticorpos Antivirais/sangue , Betacoronavirus/imunologia , Infecções por Coronavirus/epidemiologia , Recursos Humanos em Hospital/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Centros Médicos Acadêmicos , Adulto , Doenças Assintomáticas , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Infecção Hospitalar/prevenção & controle , Feminino , Humanos , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Masculino , Pessoa de Meia-Idade , Pandemias/prevenção & controle , Equipamento de Proteção Individual/estatística & dados numéricos , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Estudos Soroepidemiológicos , Estados Unidos/epidemiologia
10.
Am J Gastroenterol ; 115(10): 1575-1583, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32868631

RESUMO

The American Neurogastroenterology and Motility Society Task Force recommends that gastrointestinal motility procedures should be performed in motility laboratories adhering to the strict recommendations and personal protective equipment (PPE) measures to protect patients, ancillary staff, and motility allied health professionals. When available and within constraints of institutional guidelines, it is preferable for patients scheduled for motility procedures to complete a coronavirus disease 2019 (COVID-19) test within 48 hours before their procedure, similar to the recommendations before endoscopy made by gastroenterology societies. COVID-19 test results must be documented before performing procedures. If procedures are to be performed without a COVID-19 test, full PPE use is recommended, along with all social distancing and infection control measures. Because patients with suspected motility disorders may require multiple procedures, sequential scheduling of procedures should be considered to minimize need for repeat COVID-19 testing. The strategies for and timing of procedure(s) should be adapted, taking into consideration local institutional standards, with the provision for screening without testing in low prevalence areas. If tested positive for COVID-19, subsequent negative testing may be required before scheduling a motility procedure (timing is variable). Specific recommendations for each motility procedure including triaging, indications, PPE use, and alternatives to motility procedures are detailed in the document. These recommendations may evolve as understanding of virus transmission and prevalence of COVID-19 infection in the community changes over the upcoming months.


Assuntos
Infecções por Coronavirus/prevenção & controle , Gastroenterologia/normas , Gastroenteropatias/diagnóstico , Controle de Infecções/normas , Laboratórios/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Comitês Consultivos/normas , Betacoronavirus/patogenicidade , Técnicas de Laboratório Clínico/normas , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Gastroenterologia/métodos , Gastroenteropatias/fisiopatologia , Motilidade Gastrointestinal/fisiologia , Humanos , Controle de Infecções/instrumentação , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Seleção de Pacientes , Equipamento de Proteção Individual/normas , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Prevalência , Sociedades Médicas/normas , Triagem/normas , Estados Unidos/epidemiologia
11.
Rev Alerg Mex ; 67(2): 199-201, 2020.
Artigo em Espanhol | MEDLINE | ID: mdl-32892535
13.
Plast Reconstr Surg ; 146(2): 248e-250e, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740631
14.
Plast Reconstr Surg ; 146(2): 250e-251e, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740632
15.
Arq Neuropsiquiatr ; 78(7): 440-449, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32756857

RESUMO

INTRODUCTION: Although the 2019 severe acute respiratory syndrome coronavirus 2 infection (SARS-CoV-2, COVID-19) pandemic poses new challenges to the healthcare system to provide support for thousands of patients, there is special concern about common medical emergencies, such as stroke, that will continue to occur and will require adequate treatment. The allocation of both material and human resources to fight the pandemic cannot overshadow the care for acute stroke, a time-sensitive emergency that with an inefficient treatment will further increase mortality and long-term disability. OBJECTIVE: This paper summarizes the recommendations from the Scientific Department on Cerebrovascular Diseases of the Brazilian Academy of Neurology, the Brazilian Society of Cerebrovascular Diseases and the Brazilian Society of Neuroradiology for management of acute stroke and urgent neuro-interventional procedures during the COVID-19 pandemic, including proper use of screening tools, personal protective equipment (for patients and health professionals), and patient allocation.


Assuntos
Infecções por Coronavirus/prevenção & controle , Coronavirus , Gerenciamento Clínico , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Neurologia/normas , Pneumonia Viral/prevenção & controle , Acidente Vascular Cerebral/terapia , Betacoronavirus , Brasil , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Humanos , Pandemias/prevenção & controle , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Sociedades Médicas
16.
JCO Glob Oncol ; 6: 1248-1257, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32755479

RESUMO

PURPOSE: To understand readiness measures taken by oncologists to protect patients and health care workers from the novel coronavirus (COVID-19) and how their clinical decision making was influenced by the pandemic. METHODS: An online survey was conducted between March 24 and April 29, 2020. RESULTS: A total of 343 oncologists from 28 countries participated. The median age was 43 years (range, 29-68 years), and the majority were male (62%). At the time of the survey, nearly all participants self-reported an outbreak in their country (99.7%). Personal protective equipment was available to all participants, of which surgical mask was the most common (n = 308; 90%). Telemedicine, in the form of phone or video encounters, was common and implemented by 80% (n = 273). Testing patients with cancer for COVID-19 via reverse transcriptase polymerase chain reaction before systemic treatment was not routinely implemented: 58% reported no routine testing, 39% performed testing in selected patients, and 3% performed systematic testing in all patients. The most significant factors influencing an oncologist's decision making regarding choice of systemic therapy included patient age and comorbidities (81% and 92%, respectively). Although hormonal treatments and tyrosine kinase inhibitors were considered to be relatively safe, cytotoxic chemotherapy and immune therapies were perceived as being less safe or unsafe by participants. The vast majority of participants stated that during the pandemic they would use less chemotherapy, immune checkpoint inhibitors, and steroids. Although treatment in neoadjuvant, adjuvant, and first-line metastatic disease was less affected, most of the participants stated that they would be more hesitant to recommend second- or third-line therapies in metastatic disease. CONCLUSION: Decision making by oncologists has been significantly influenced by the ongoing COVID-19 pandemic.


Assuntos
Betacoronavirus/patogenicidade , Tomada de Decisão Clínica , Infecções por Coronavirus/prevenção & controle , Controle de Infecções/estatística & dados numéricos , Neoplasias/terapia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adulto , Idoso , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Feminino , Humanos , Controle de Infecções/métodos , Controle de Infecções/normas , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Masculino , Oncologia/métodos , Oncologia/normas , Oncologia/estatística & dados numéricos , Pessoa de Meia-Idade , Neoplasias/diagnóstico , Oncologistas/estatística & dados numéricos , Equipamento de Proteção Individual/normas , Equipamento de Proteção Individual/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia , Padrões de Prática Médica/normas , Padrões de Prática Médica/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Telemedicina/estatística & dados numéricos
17.
Surgery ; 168(4): 572-577, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32739140

RESUMO

BACKGROUND: Resumption of elective surgery during the current coronavirus disease 2019 pandemic crisis has been debated widely and largely discouraged. The aim of this prospective cohort study was to assess the feasibility of resuming elective operations during the current and possible future peaks of this coronavirus disease 2019 pandemic. METHODS: We collected data during the peak of the current pandemic in the United Kingdom on adult patients who underwent elective surgery in a "COVID-19-free" hospital from April 8 to May 29, 2020. The study included patients from various surgical specialties. Nonelective and pediatric cases were excluded. The primary outcome was 30-day mortality postoperatively. Secondary outcomes were the rate of coronavirus disease 2019 infections, new onset of pulmonary symptoms after hospitalization, and requirement for admission to the intensive care unit. RESULTS: A total of 309 consecutive adult patients were included in this study. No patients died nor required intensive care unit admission. Operations graded "Intermediate" were the most performed procedure representing 91% of the total number. One patient was diagnosed with a coronavirus disease 2019 infection after being transferred to the nearest local emergency hospital for management of postoperative pain secondary to common bile duct stone and was successfully treated conservatively on the ward. No patient developed pulmonary complications. Three patients were admitted for greater than 23 hours. Twenty-seven patients (8.7%) developed complications. Complications graded as 2 and 3 according to the Clavien-Dindo classification occurred in 14 and 2 patients, respectively. CONCLUSION: This prospective study shows that, despite the severity and high transmissibility of novel coronavirus 2 disease, COVID-19-free hospitals can represent a safe setting to resume many types of elective surgery during the peak of a pandemic.


Assuntos
Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos Eletivos/normas , Controle de Infecções/normas , Pandemias/prevenção & controle , Admissão do Paciente/normas , Pneumonia Viral/prevenção & controle , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico/normas , Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Estudos de Viabilidade , Feminino , Mortalidade Hospitalar , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Unidades de Terapia Intensiva/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Admissão do Paciente/estatística & dados numéricos , Seleção de Pacientes , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Complicações Pós-Operatórias/etiologia , Estudos Prospectivos , Resultado do Tratamento , Reino Unido/epidemiologia
18.
Am J Gastroenterol ; 115(10): 1719-1721, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32852334

RESUMO

INTRODUCTION: The risk of coronavirus disease-19 infection for healthcare professionals and patients in hospitals remains unclear. METHODS: We investigated whether precautions adopted in our inflammatory bowel disease (IBD) unit have minimized the risks of infection for all patients accessing our facilities in a 1-month period by assessing the rate of coronavirus disease-19 infection in the follow-up period. RESULTS: Three hundred-twenty patients with IBD were included. None were infected from severe acute respiratory syndrome-coronavirus 2 in the follow-up period. None of the IBD team members were infected. DISCUSSION: Neither pharmacological immunosuppression nor access to the hospital seem to be risk factors for infection in patients with IBD.


Assuntos
Infecções por Coronavirus/prevenção & controle , Unidades Hospitalares/estatística & dados numéricos , Imunossupressores/efeitos adversos , Controle de Infecções/estatística & dados numéricos , Doenças Inflamatórias Intestinais/imunologia , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus/imunologia , Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/imunologia , Seguimentos , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/estatística & dados numéricos , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/estatística & dados numéricos , Doenças Inflamatórias Intestinais/tratamento farmacológico , Itália/epidemiologia , Pessoa de Meia-Idade , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/imunologia , Fatores de Risco , Adulto Jovem
19.
Clinics (Sao Paulo) ; 75: e2083, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32756820

RESUMO

Questions regarding the transmissibility of the novel coronavirus disease (COVID-19) remain unanswered. It is known that the transmission of the severe acute respiratory syndrome coronavirus (SARS-CoV) occurs predominantly through droplets and contact. However, aerosols can be generated in some situations, such as orotracheal intubation, ventilation, and the use of electric or ultrasonic scalpels, and can therefore potentially contaminate the care team if adequate protection is not used. It is therefore necessary to assess issues of transmissibility of COVID-19 during surgery in infected patients. This review gathers the recent research pertaining to this topic. A search of the literature was performed using the PubMed and UpToDate databases with the search terms "surgery" and "covid-2019," in addition to other MeSH variants of these terms. We do not have consistent evidence on the exposure of healthcare professionals assisting patients with COVID-19 undergoing laparoscopy or the impact of such exposure. In view of the evidence obtained and drawing parallels with other infectious and contagious diseases, medical personnel must wear complete protective attire for proper protection against the generated aerosol. Further studies are required to assess the impact of such surgeries on healthcare professionals conducing or assisting with these procedures.


Assuntos
Infecções por Coronavirus/prevenção & controle , Coronavirus , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Laparoscopia/métodos , Pneumonia Viral/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão
20.
MMWR Morb Mortal Wkly Rep ; 69(32): 1095-1099, 2020 Aug 11.
Artigo em Inglês | MEDLINE | ID: mdl-32790655

RESUMO

Undetected infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) contributes to transmission in nursing homes, settings where large outbreaks with high resident mortality have occurred (1,2). Facility-wide testing of residents and health care personnel (HCP) can identify asymptomatic and presymptomatic infections and facilitate infection prevention and control interventions (3-5). Seven state or local health departments conducted initial facility-wide testing of residents and staff members in 288 nursing homes during March 24-June 14, 2020. Two of the seven health departments conducted testing in 195 nursing homes as part of facility-wide testing all nursing homes in their state, which were in low-incidence areas (i.e., the median preceding 14-day cumulative incidence in the surrounding county for each jurisdiction was 19 and 38 cases per 100,000 persons); 125 of the 195 nursing homes had not reported any COVID-19 cases before the testing. Ninety-five of 22,977 (0.4%) persons tested in 29 (23%) of these 125 facilities had positive SARS-CoV-2 test results. The other five health departments targeted facility-wide testing to 93 nursing homes, where 13,443 persons were tested, and 1,619 (12%) had positive SARS-CoV-2 test results. In regression analyses among 88 of these nursing homes with a documented case before facility-wide testing occurred, each additional day between identification of the first case and completion of facility-wide testing was associated with identification of 1.3 additional cases. Among 62 facilities that could differentiate results by resident and HCP status, an estimated 1.3 HCP cases were identified for every three resident cases. Performing facility-wide testing immediately after identification of a case commonly identifies additional unrecognized cases and, therefore, might maximize the benefits of infection prevention and control interventions. In contrast, facility-wide testing in low-incidence areas without a case has a lower proportion of test positivity; strategies are needed to further optimize testing in these settings.


Assuntos
Técnicas de Laboratório Clínico , Infecções por Coronavirus/prevenção & controle , Casas de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Idoso , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Pessoal de Saúde , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Estados Unidos/epidemiologia
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA