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1.
Medicine (Baltimore) ; 100(3): e24077, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33546011

RESUMO

ABSTRACT: This study aimed to systematically analyze the effect of Wuhan mobile cabin hospitals (WMCHs) on the novel coronavirus-caused pneumonia (COVID-19) prevention and control in China. Between February 5, 2020 and March 10, 2020, a total of 16 mobile cabin hospitals were constructed in 3 batches to offer over 13,000 beds and admitted more than 12,000 patients in Wuhan City. The strategy of implementing WMCHs in 3 batches played a key role in fighting against COVID-19 in China. (1) The first batch of WMCHs increased hospital admission capacity of COVID-19 patients in Wuhan, which showed initial effect on COVID-19 epidemic control. (2) The operation of the second batch of WMCHs greatly contributed to the rapid growth in discharged patients. (3) After launching the third batch of WMCHs, the COVID-19 epidemic situation in Wuhan improved considerably. The last batch of WMCHs made a substantial contribution to defeating the COVID-19 epidemic in Wuhan.


Assuntos
/epidemiologia , Política de Saúde , Unidades Móveis de Saúde/organização & administração , China/epidemiologia , Número de Leitos em Hospital , Hospitalização , Humanos
3.
J Nepal Health Res Counc ; 18(4): 785-788, 2021 Jan 22.
Artigo em Inglês | MEDLINE | ID: mdl-33510529

RESUMO

Mobile Swab Collection Vehicle is a concept that has been innovated by a team of medical and non-medical personals based upon the dire need to perform throat or nasopharyngeal swab collections to do reverse transcription polymerase chain reaction  'RT-PCR' quickly, safely, and comfortably during this Corona Virus Diseases 2019, 'COVID-19' pandemic in a resource-poor country like Nepal. Inputs from the health care workers, beneficiaries, and engineers have been taken to construct this vehicle-mounted booth for swab collection. This vehicle is the 'first of its kind' in Nepal. Keywords: COVID-19; Nepal; swab collection vehicle.


Assuntos
/métodos , Unidades Móveis de Saúde/organização & administração , Reação em Cadeia da Polimerase Via Transcriptase Reversa/métodos , Manejo de Espécimes/métodos , Humanos , Nepal
4.
Medicine (Baltimore) ; 100(1): e23676, 2021 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-33429734

RESUMO

INTRODUCTION: Ischemic stroke caused by arterial occlusion is the cause of most strokes. The focus of treatment is rapid reperfusion through intravenous thrombolysis and intravascular thrombectomy. Two acute stroke management including prehospital thrombolysis and in hospital have been widely used clinically to treat ischemic stroke with satisfied efficacy. However, there is no systematic review comparing the effectiveness of these 2 therapies. The aim of this study is to compare the effect of prehospital thrombolysis versus in hospital for patients with ischemic stroke. METHODS AND ANALYSIS: The following electronic databases will be searched: Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), Wanfang Database, and Chinese Scientific Journal Database.The randomized controlled trials of prehospital thrombolysis versus in hospital for ischemic stroke will be searched in the databases from their inception to December 2020 by 2 researchers independently. Onset to therapy (OTT) duration and National Institute Health Stroke Scale (NIHSS) scores will be assessed as the primary outcomes; safety assessment including intracerebral hemorrhage (ICH) and mortality will be assessed as the secondary outcomes. The Review Manager 5.3 will be used for meta-analysis and the evidence level will be assessed by using the method for Grading of Recommendations Assessment, Development and evaluation Continuous outcomes will be presented as the weighted mean difference or standardized mean difference with 95% confidence interval (CI), whereas dichotomous data will be expressed as relative risk with 95% CI. If heterogeneity existed (P < .05), the random effect model was used. Otherwise, we will use the fixed effect model for calculation. ETHICS AND DISSEMINATION: Ethical approval is not required because no primary data are collected. This review will be published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42020200708.


Assuntos
Protocolos Clínicos , Hospitais/normas , Unidades Móveis de Saúde/normas , Terapia Trombolítica/normas , Hospitais/estatística & dados numéricos , Humanos , Metanálise como Assunto , Unidades Móveis de Saúde/organização & administração , Unidades Móveis de Saúde/estatística & dados numéricos , Ensaios Clínicos Controlados Aleatórios como Assunto , Revisões Sistemáticas como Assunto , Terapia Trombolítica/métodos , Terapia Trombolítica/estatística & dados numéricos
6.
J Subst Abuse Treat ; 120: 108149, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33303086

RESUMO

The Youth Opioid Recovery Support (YORS) intervention is a novel treatment for young adults with opioid use disorder (OUD) that uses developmentally informed strategies to reduce barriers to treatment engagement. YORS strategies, such as home delivery of extended-release buprenorphine and extended-release naltrexone for OUD, are designed to increase engagement in treatment, but with the COVID-19 pandemic these strategies increase risk of virus exposure and spread to patients and staff entering homes. We present mobile van service delivery as a potential solution to continuing to provide low-barrier care for young adults with OUD while reducing risk associated with COVID-19. Initial feedback from patients and staff is positive and lays the groundwork to test feasibility and acceptability of this intervention rigorously in future work. Mobile van delivery of extended-release medications for OUD may be a promising treatment modification for mitigating risk of COVID-19, as well as a useful option for ongoing enhancement of care.


Assuntos
Buprenorfina/administração & dosagem , Unidades Móveis de Saúde , Naltrexona/administração & dosagem , Preparações de Ação Retardada , Humanos , Tratamento de Substituição de Opiáceos/métodos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Adulto Jovem
7.
Soins Psychiatr ; 41(331): 39-41, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33357667

RESUMO

Based on a clinical situation of a patient infected with COVID-19, the caregivers of the Saint-Étienne mobile psychiatric team describe their anxieties. Are the procedures carried out appropriate? Did we respect the safety measures? Are we at risk of contracting the virus and contaminating other people? The scientific discourse of "experts", who used to guide our actions, has throughout this crisis been inadequate and people's beliefs have crumbled. This abandonment is a source of anxiety for everyone, an anxiety about death. However, this reflection should kindle hope, a precious emotion for those working with patients in psychiatry.


Assuntos
Ansiedade/psicologia , Cuidadores/psicologia , Transtornos Mentais/terapia , /epidemiologia , França/epidemiologia , Humanos , Unidades Móveis de Saúde , Equipe de Assistência ao Paciente , Filosofia
8.
Soins ; 65(849): 22-27, 2020 Oct.
Artigo em Francês | MEDLINE | ID: mdl-33357613

RESUMO

The militaryintensive care field hospital is a new tool set up by the military medical service as part of Operation Resilience to provide medical support in the regions of France most affected by the SARS-Cov-2 pandemic. Deployed in Mulhouse and Mayotte, this hospital facility is a functional intensive care unit set up to support an existing hospital structure. The caregivers and logistics specialists are all from the military medical service, active personnel or reservists, predominantly nurses. The implementation of this intensive care field hospital in a constrained environment requires an efficient provision of care in accordance with medical guidelines, while protecting the healthcare staff and, notably, the frontline nursing staff.


Assuntos
Unidades de Terapia Intensiva/organização & administração , Medicina Militar , Unidades Móveis de Saúde/organização & administração , Cuidados Críticos , França , Humanos , Militares
9.
J Glob Health ; 10(2): 021103, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33312513

RESUMO

Background: To prevent the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), strict control of person-to-person transmission is essential. Family transmission is the most common route of transmission; however, family transmission patterns and outcomes are not well understood. Methods: We enrolled confirmed cases discharged from Wuhan Zhuankou Fangcang Shelter Hospital from February 17, 2020 to March 8, 2020 along with the family members they had contact with, to evaluate baseline characteristics, family transmission patterns and outcomes. The follow-up period lasted until May 8, 2020. Results: This study evaluated 369 participants, which included 100 patients admitted to the shelter hospital and the family members they had contact with. Family transmission occurred in 62% of household, with 190 cases confirmed to have SARS-CoV-2 infection. There were eight patterns of family transmission, and spousal transmission (44/83, 53.0%) was the most common pattern, especially in the middle-age generation group (35/83, 42.2%). The homes of the families in which all members were infected had a smaller per capita area than those of other families (29.1 ± 11.89 cm2 vs 41.0 ± 19.70 cm2, respectively, P = 0.037), and the per capita area was negatively associated with the number of infected family members (R = -0.097, P = 0.048). Of the 190 confirmed cases, the 113 mild or moderate cases were monitored in fangcang (including Wuhan Zhuankou Fangcang and other fangcang), and the 59 severe cases were treated at designated hospitals. By the end of follow-up, 185 patients recovered and returned home after completing at least 14 days of isolation at the community quarantine center, four died in hospitals, and one died at home before hospitalization. Interestingly, four patients had positive nucleic acid test results after previous negative results, though none of these patients were re-hospitalized, and none of their close contacts reported an infection. Conclusions: Our data found eight family transmission patterns, of which spousal transmission was the most common. Some patients were also found to have positive test results during follow-up.


Assuntos
/epidemiologia , Família , Adolescente , Adulto , Idoso , Criança , China/epidemiologia , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Unidades Móveis de Saúde , Pandemias , Índice de Gravidade de Doença , Adulto Jovem
11.
Afr J Prim Health Care Fam Med ; 12(1): e1-e4, 2020 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-33181872

RESUMO

This short report captures the week-by-week reflections of a group of family physicians who joined the clinical and operational management teams tasked with providing the in-patient service of an 862-bed COVID-19 field hospital. The 'Hospital of Hope' at the Cape Town International Convention Centre (CTICC) was established as an intermediate care facility specifically to cope with the effects of the COVID-19 pandemic in Cape Town metropole. In an extraordinary feat of engineering, the conference centre floor was transformed within a matter of weeks into wards with piped oxygen at each bed. Whilst the emergency medicine specialists took the lead in designing and commissioning the facility, the medical management and staff were drawn mostly from family physicians. This report is a short reflection on the experience of the first 4 weeks of managing patients in this repurposed space. Our insights evolved during various formal and informal learning conversations as the in-patient service became more organised over time. We hope that these insights, as well as the process of reaching them, will assist other colleagues in serving their communities during this difficult moment in history; moreover, it may reflect a renewed appreciation for team-based interdisciplinary efforts in achieving person-centred care.


Assuntos
Infecções por Coronavirus/terapia , Assistência à Saúde/métodos , Hospitalização , Hospitais , Pandemias , Equipe de Assistência ao Paciente , Médicos de Família , Pneumonia Viral/terapia , Betacoronavirus , Administração de Caso , Cidades , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Serviços Médicos de Emergência , Humanos , Unidades Móveis de Saúde , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , África do Sul/epidemiologia
12.
Soins Psychiatr ; 41(329): 23-26, 2020.
Artigo em Francês | MEDLINE | ID: mdl-33129401

RESUMO

The mission of the mobile ethnopsychiatry team (EMIE) is to provide consultations to patientsfrom an emigrantbackground whopresent problems of acultural nature. Ayoung Congolese is in the grip of rituals and black magic.Heistorn between his father'sinfluence,his mother'sopinions and his place in the familycircle.His story is aperfect illustration of the specific role of the EMIE in the health and immigrant caresystem.


Assuntos
Emigrantes e Imigrantes , Transtornos Mentais , Religião e Medicina , Emigrantes e Imigrantes/psicologia , Humanos , Transtornos Mentais/terapia , Unidades Móveis de Saúde , Encaminhamento e Consulta
13.
J Am Med Dir Assoc ; 21(11): 1563-1567, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33138938

RESUMO

During the surge of Coronavirus Disease 2019 (COVID-19) infections in March and April 2020, many skilled-nursing facilities in the Boston area closed to COVID-19 post-acute admissions because of infection control concerns and staffing shortages. Local government and health care leaders collaborated to establish a 1000-bed field hospital for patients with COVID-19, with 500 respite beds for the undomiciled and 500 post-acute care (PAC) beds within 9 days. The PAC hospital provided care for 394 patients over 7 weeks, from April 10 to June 2, 2020. In this report, we describe our implementation strategy, including organization structure, admissions criteria, and clinical services. Partnership with government, military, and local health care organizations was essential for logistical and medical support. In addition, dynamic workflows necessitated clear communication pathways, clinical operations expertise, and highly adaptable staff.


Assuntos
Comportamento Cooperativo , Infecções por Coronavirus/epidemiologia , Unidades Móveis de Saúde/organização & administração , Pandemias , Pneumonia Viral/epidemiologia , Idoso , Betacoronavirus , Boston/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Admissão e Escalonamento de Pessoal/organização & administração , Instituições de Cuidados Especializados de Enfermagem , Cuidados Semi-Intensivos
14.
Biochem Med (Zagreb) ; 30(3): 030403, 2020 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-33071554

RESUMO

To fight the virus SARS-CoV-2 spread to Europe from China and to give support to the collapsed public health system, the Spanish Health Authorities developed a field hospital located in the facilities of Madrid exhibition centre (IFEMA) to admit and treat patients diagnosed with SARS-CoV-2 infectious disease (COVID-19). The Department of Laboratory Medicine of La Paz University Hospital in Madrid (LMD-HULP) was designated to provide laboratory services. Due to the emergency, the IFEMA field hospital had to be prepared for patient admission in less than 1 week and the laboratory professionals had to collaborate in a multidisciplinary group to assure that resources were available to start on time. The LMD-HULP participated together with the managers in the design of the tests portfolio and the integration of the healthcare information systems (IS) (hospital IS, laboratory IS and POCT management system). Laboratorians developed a strategy to quickly train clinicians and nurses on test requests, sample collection procedures and management/handling of the POCT blood gas analyser both by written materials and training videos. The IFEMA´s preanalytical unit managed 3782 requests, and more than 11,000 samples from March 27th to April 30th. Furthermore, 1151 samples were measured by blood gas analysers. In conclusion, laboratory professionals must be resilient and have to respond timely in emergencies as this pandemic. The lab's personnel selection, design and monitoring indicators to maintain and further improve the quality and value of laboratory services is crucial to support medical decision making and provide better patient care.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Unidades Móveis de Saúde/organização & administração , Pandemias , Pneumonia Viral , Cidades , Sistemas de Informação em Laboratório Clínico/organização & administração , Infecções por Coronavirus/epidemiologia , Assistência à Saúde , Necessidades e Demandas de Serviços de Saúde , Número de Leitos em Hospital , Sistemas de Informação Hospitalar/organização & administração , Hospitais Universitários/organização & administração , Humanos , Laboratórios Hospitalares/organização & administração , Recursos Humanos em Hospital/educação , Pneumonia Viral/epidemiologia , Testes Imediatos/organização & administração , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Espanha , Manejo de Espécimes
15.
Rev Bras Enferm ; 73(suppl 2): e20200487, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-33111781

RESUMO

OBJECTIVE: Reflect and propose adaptations to the Multimodal Hand Hygiene Strategy for field hospitals, in the context of the COVID-19 pandemic. METHOD: Reflective study, carried out in April 2020, based on the recommendations of the World Health Organization and the guide for the implementation of the five components of the Multimodal Strategy: system change related to infrastructure; training/education; evaluation and feedback; reminders in the workplace; and institutional security climate. RESULTS: The Multimodal Strategy, proposed for hospitals in general, can be adapted for field hospitals in order to reduce the transmission of the SARS-CoV-2 virus. Investments to adapt the infrastructure and education of workers require foresight and speed and are of special relevance to promote hand hygiene in this care context. FINAL CONSIDERATIONS: Adjusting the Multimodal Strategy, especially for the reduced time in the execution of each component, is necessary for field hospitals with a view to preventing COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Higiene das Mãos/métodos , Unidades Móveis de Saúde , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Guias como Assunto , Higiene das Mãos/organização & administração , Humanos , Segurança do Paciente , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Organização Mundial da Saúde
16.
S Afr Med J ; 110(9): 835-836, 2020 08 12.
Artigo em Inglês | MEDLINE | ID: mdl-32880262

RESUMO

The stated objective of the COVID-19 lockdown was to allow time to prepare healthcare facilities. Preparation must include administrative and environmental measures, which when combined with personal protective equipment, minimise the risk of the spread of infection to patients and healthcare workers (HCWs) in facilities, allowing HCWs to safely provide essential services during the pandemic and limit the indirect effects of COVID-19 caused by healthcare disruption. We present our model for facility preparation based on colour-coded zones, social distancing, hand hygiene, rapid triage and separate management of symptomatic patients, and attention to infection transmission prevention between HCWs in communal staff areas. This model specifically addresses the challenges in preparing a facility for COVID-19 in a low-resource setting and in rural areas. In addition, we include links to resources to allow workers in low-resource settings to prepare their facilities adequately.


Assuntos
Infecções por Coronavirus/epidemiologia , Assistência à Saúde/organização & administração , Instalações de Saúde , Pessoal de Saúde , Pneumonia Viral/epidemiologia , Instituições de Assistência Ambulatorial , Betacoronavirus , Fortalecimento Institucional , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Desinfecção , Planejamento Ambiental , Desinfecção das Mãos , Hospitais , Humanos , Controle de Infecções , Unidades Móveis de Saúde , Pandemias/prevenção & controle , Equipamento de Proteção Individual/provisão & distribução , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , África do Sul/epidemiologia , Ventiladores Mecânicos/provisão & distribução
17.
Int J Med Sci ; 17(14): 2125-2132, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32922173

RESUMO

Objectives: To present the temporal changes of CT manifestations in COVID-19 patients from a single fangcang shelter hospital and to facilitate the understanding of the disease course. Materials and Methods: This retrospective study included 98 patients (males: females, 43:55, mean year, 49±12 years) with confirmed COVID-19 at Jianghan fangcang shelter hospital admitted between Feb 05, 2020, and Feb 09, 2020, who had initial chest CTs at our hospital. Radiographic features and CT scores were analyzed. Results: A total of 267 CT scans of 98 patients were evaluated. Our study showed a high median total CT score of 7 within the first week from symptom onset, peaked in the 2nd week at 10, followed by persistently high levels of CT score with 9.5, 7 and 7 for the week 3, 4, and >4, respectively, and a prolonged median disease course (30 days, the median interval between the onset of initial symptoms and discharge). Ground-glass opacity (GGO) (58%, 41/71) was the earliest and most frequent finding in week 1. Consolidation (26%, 14/53) and mixed pattern (40%, 21/53) were predominant patterns in 2nd week. GGO and reticular were the main patterns of later phase CT scans in patients with relatively advanced diseases who had longer illness duration (≥4 weeks). Among the 94 CT abnormalities obtained within 3 days from the twice RT-PCR test turned negative, the mixed pattern was mainly presented in patients with disease duration of 2-3 weeks, for GGO and reticular were common during the whole course. Conclusion: Discharged patients from fangcang shelter hospital demonstrated a high extent of lung abnormalities on CT within the first week from symptom onset, peaked at 2nd week, followed by persistence of high levels and a prolonged median disease course. GGO was the predominant pattern in week 1, consolidation and mixed pattern in 2nd week, whereas GGO and reticular patterns in later stages (≥4 weeks).


Assuntos
Betacoronavirus/isolamento & purificação , Técnicas de Laboratório Clínico/estatística & dados numéricos , Infecções por Coronavirus/diagnóstico , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico , Tomografia Computadorizada por Raios X/estatística & dados numéricos , Adolescente , Adulto , Idoso , Betacoronavirus/genética , China/epidemiologia , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Unidades Móveis de Saúde , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , RNA Viral/isolamento & purificação , Estudos Retrospectivos , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Índice de Gravidade de Doença , Adulto Jovem
19.
Updates Surg ; 72(3): 565-572, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32876884

RESUMO

Medical services in WWI had to face enormous new problems: masses of wounded, most with devastating wounds from artillery splinters, often involving body cavities, and always contaminated. Tetanus, gas gangrene, wound infections were common and often fatal. Abdominal wounds were especially a problem: upon entering the war the commanders of all medical services ordered to avoid surgery, based on dismal experiences of previous wars. Surgical community divided into non-operative and operative treatment supporters. The problem seemed mainly organizational, as the wounded were rescued after many hours and treated by non-specialist doctors, in inadequate frontline settings or evacuated back with further delay of treatment. During initial neutrality, Italian Academics closely followed the debate, with different positions. Many courses and publications on war surgery flourished. Among the interventionists, Baldo Rossi, to provide a setting adequate to major operations close to the frontline, with trained surgeons and adequate instruments, realized for the Milano Red Cross three fully equipped, mobile surgical hospitals mounted on trucks, with an operating cabin-tent, with warming, illumination and sterilizing devices, post-operative tents and a radiological unit. Chiefs of the army approved the project and implemented seven similar units, called army surgical ambulances, each run by a distinguished surgeon. Epic history and challenges of the mobile units at the frontline, brilliant results achieved on war wounds and epidemics are described. After the war they were considered among the most significant novelties of military medical services. Parallels with present scenarios in war and peace are outlined.


Assuntos
Unidades Móveis de Saúde/história , Centro Cirúrgico Hospitalar/história , I Guerra Mundial , Ferimentos e Lesões , Surtos de Doenças , História do Século XX , Humanos , Itália
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